Clinton County Application for Promotional Exam/Appointment

Contact Information

Promotional Exam Applicant Name

First

Middle

Last

Social Security Number

Promotional Exam Applicant Address

Address

Address 2

City/Town

State

- Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip

Email Address

Exam Information

Select Exam Title and Number

- Select -70-474: 'Probation Assistant (Probation) (PROM) - 70-474'72-725: 'Probation Director (Group A) (Probation) (PROM) - 72-725'73-149: 'Probation Officer 2 / Sr Probation Officer (Probation) (PROM) - 73-149'72-895: 'Probation Supervisor I (Probation) (PROM) - 72-895'

Conflicting Exams

Conflicting Exams

I have applied for a NYS Civil Service Exam or another Local Exam being offered on the same day, excluding New York City:

Yes

No

Indicate the titles of the exams and whether they are offered by another Local agency or the State. If you are taking two Local exams, indicate in which county you want to take the exams. If you are taking a Local and State exam, you must take the exams at the State site.

Veteran Information

Veterans Credit

Would you like to claim War Time Veterans Credits for this exam? If YES, you MUST complete an Application for Veterans' Credits.

Yes

No

Affirmation of Accuracy

Under penalties of perjury, I affirm that all information concerning my exempt volunteer firefighter status, veteran status,
citizenship, arrests and convictions, dismissal from employment, and discharge from the Armed Forces
listed on my application on file is current and accurate.

Correct Application Accuracy

Special Arrangements

Special Arrangements for Civil Service Exam:

Promotional Exam Signature

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