WCCCA Employment Interest Form

Public Safety Dispatcher

A FELONY conviction under state or federal law, or a MISDEMEANOR conviction relating to domestic violence, automatically precludes consideration for employment. Adverse background discovery may be grounds for disqualification. View a list of disqualifiers here.

* Required Fields
* First Name:
MI:
* Last Name:
* Address:
* City:
* State
* Zip:
* Phone:	( xxx-xxx-xxxx )
Email:
Source of Job Interest:
**Employment interest information will be saved for 6 months