Official SealHuman Resource Services Department

Supplemental Questionnaire

Last Name
First Name


Thank you for your interest in the position of Deputy Sheriff - Services-As-Needed (SAN), Examination #20-8603N-01.  Applicants for this position are required to submit responses to the following supplemental questions.  Your completed responses to the supplemental questionnaire will be evaluated to further verify minimum qualifications.  Failure to answer these questions truthfully may result in disqualification from the examination process.


Do you possess a high school diploma or an acceptable equivalency certificate, such as the General Education Development Certificate (State of California)?

Yes No

Do you possess a minimum of 36 months full-time experience as a Peace Officer in a non-37 Act retirement system in a California law enforcement agency (municipality, Sheriff, High Patrol) within the last three years?

Relevant experience should be reflected in the Employment History portion of your online application.

Yes No

Do you possess a valid California Basic P.O.S.T. certificate or recertification certificate?

If you answered "yes," certificate information should be reflected in the Professional Credentials portion of your online application.

Yes No

Please check the box to the left if you agree with the statements below:

As stated on the examination bulletin, the following are special requirements:  Federal law and County policy requires that certain positions in the class of Deputy Sheriff - Services-As-Needed, which require a commercial driver's license and the performance of duties defined as "safety sensitive," are subject to post-offer/pre-placement/pre-duty, reasonable suspicion, post-accident, random, return-to-duty and follow-up drug and alcohol testing.  A thorough background investigation will be made of all prospective Deputy Sheriffs - Services-As-Needed.  A record of any felony conviction will result in disqualification.

CERTIFICATION OF APPLICANT:  I hearby certify that I am the author of this questionnaire and that all information presented is true and based on my background, skills, and experience.  I agree and understand that misstatements or omission of material facts herein may forfeit my rights to any employment in the service of the County of Alameda.



Questions #5 through #7 are required in accordance within the Federal Prison Rape Elimination Act (PREA) of 2003, Standard 115.17/115.117/115.217/115.317.

Have you ever:


Engaged in sexual abuse in a prison, jail, lockup, community confinement facility, juvenile facility, or other institution (as defined in 42 U.S.C. 1997)?

Yes No

Been convicted of engaging or attempting to engage in sexual activity in the community facilitated by force, overt or implied threats of force, or coercion, or if the victim did not consent or was unable to consent or refuse?

Yes No

Been civilly or administratively adjudicated to have engaged in the activity described in question #6?

Yes No