Belen Police Department Online Interest Form

If you are interested in becoming a police officer with the City of Belen complete the online interest form below and submit it. This is not an application for employment, but instead it is a pre-application of intent. A formal application will be mailed to you upon acceptance of this application. Recruitment of police officers for the City of Belen is an ongoing process and never closed. These pre-applications remain on file for six months. You may complete this form again in six months. Before submitting information on this form, please read and understand the disclaimer on the "About the Website" page of this site.
Application of Intent Date:
Applicant First, Middle and Last Name:
Applicant Mailing Address:
City:	St:		Zip:
Best Phone Number To Reach You At:
E-Mail Address:
A cursory review of your background will be done based on the following information.
Year of Birth:
Driver License #:		State Issued:
Expiration Date:


US Citizen:	Yes	No
Are you at least 21 years old?:	Yes	No
Do you have a High School Diploma?	Yes	No
Do you have a G.E.D?	Yes	No
Have you ever been convicted of a felony?	Yes	No
Any DWI arrests in the last 3 years?	Yes	No
Any misdemeanor arrests in the last 3 years?	Yes	No
Have you ever been convicted of Domestic Violence?	Yes	No
Do you have a previous application with the Police Department?	Yes	No
Please indicate the date of that application:
Any Military service	Yes	No
Type of discharge:
Last date illegal drugs were used (m/y)

THE CITY OF BELEN IS AN EQUAL OPPERTUNITY EMPLOYER