Deputy Sheriff

Madison County, Virginia
Application Instructions for Full-Time Deputy Sheriff

April 11, 2025

Madison County Sheriff’s Office is accepting applications for the position of Deputy Sheriff.
Information on Madison County, the position and the application procedures can be found
at https://www.madisonco.virginia.gov/. Applications will be received until the position is
filled. EOE

Following is supplementary information on the position and application instructions for all
interested individuals:

Full-time employees are eligible for VRS Retirement, employee health insurance (currently
Local Choice-Blue Cross/Blue Shield) benefits, and holiday and vacation/sick paid time off.
The current Madison County Personnel Policy is available on the County website. Part-time
positions are not eligible for these benefits. The hiring rate will depend upon the
qualifications of the individual selected.

Applicants are to complete an employment applicant and the Authorization of Release of
Information Form and return it to Madison County Sheriff’s Office; P.O. Box 322; Madison, VA
22727 or tnestes@madisonco.virginia.gov. Resumes (and limited additional relevant
documentation) are encouraged and will be accepted but will not be considered a substitute
for a completed County application form. Unsigned applications will not be considered.
General inquiries by the applicant via telephone or in person are discouraged.

Deputy Sheriff

Department: Location: Job Type: FLSA Status: Pay Grade:

Sheriff 115 Church St. Full-Time Non-Exempt PS7

G eneral Definition of Work:
Performs protective service work enforcing laws, patrolling assigned area, investigating criminal
activity, serving civil papers, ensuring safety of the public, testifying in court, maintaining records and
files, preparing reports, and related work as apparent or assigned. Work is performed under the limited
supervision of the Sheriff.

Q ualification Requirements:
To perform this job successfully, an individual must be able to perform each essential function
satisfactorily. The requirements listed below are representative of the knowledge, skill and/or
ability required. Reasonable accommodations may be made to enable an individual with
disabilities to perform the essential functions.

Essential Functions:

• On an assigned shift, operates a patrol vehicle to observe for violations of traffic laws,

• Serves warrants, summons, subpoenas, civil process papers and makes arrests, forcibly if

• Enforces traffic laws; issues citations for traffic violations; performs radar enforcement, DUI

• Conducts and documents security checks of homes, neighborhoods, and businesses in assigned

• Assists other law enforcement officers and agencies on various tasks.
• Operates computer to run checks, criminal histories, missing person’s checks, etc.
• Assists with criminal investigations by preserving, recording and presenting evidence,

SRO/D.A.R.E., etc. or other special assignments as qualified and assigned.

Knowledge, Skills and Abilities:
Thorough knowledge of law enforcement methods, practices and procedures; general knowledge of the
geography of the County and location of important buildings; thorough knowledge of the rules and
regulations of the Sheriff's Office; skill in the use of firearms, chemical agents, weapons of defense and

Madison County, Virginia

the operation of a motor vehicle; possession of physical agility and endurance; ability to understand
and carry out oral and written instructions and to prepare clear comprehensive reports; ability to deal
courteously, firmly and tactfully with the public under stressful situations; ability to analyze situations
and to adopt quick, effective and reasonable courses of action with due regard to surrounding hazards
and circumstances; ability to establish and maintain effective working relationships with associates and
the general public.

Education and Experience:
High school diploma or GED and minimal experience in law enforcement, or equivalent combination
of education and experience.

P hysical Requirements:
This work requires the regular exertion of up to 10 pounds of force, frequent exertion of up to 25
pounds of force and occasional exertion of up to 100 pounds of force; work regularly requires sitting,
speaking or hearing and repetitive motions, frequently requires standing, using hands to finger, handle
or feel, reaching with hands and arms and tasting or smelling and occasionally requires walking,
climbing or balancing, stooping, kneeling, crouching or crawling, pushing or pulling and lifting; work
requires close vision, distance vision, ability to adjust focus, depth perception, color perception, night
vision and peripheral vision; vocal communication is required for expressing or exchanging ideas by
means of the spoken word and conveying detailed or important instructions to others accurately, loudly
or quickly; hearing is required to perceive information at normal spoken word levels and to receive
detailed information through oral communications and/or to make fine distinctions in sound; work
requires of measuring devices, assembly or fabrication of parts within arm’s length, operating
machines, operating motor vehicles or equipment and observing general surroundings and activities;
work regularly requires exposure to outdoor weather conditions and exposure to bloodborne pathogens
and may be required to wear specialized personal protective equipment, frequently requires exposure to
vibration and occasionally requires wet, humid conditions (non-weather), working near moving
mechanical parts, working in high, precarious places, exposure to fumes or airborne particles, exposure
to toxic or caustic chemicals, exposure to the risk of electrical shock and wearing a self-contained
breathing apparatus; work is generally in a loud noise location (e.g. grounds maintenance, heavy
traffic).

Requirements:
• Possession of Virginia Department of Criminal Justice Services (DCJS) Basic Law

Madison County, Virginia

DHRM Form 10-012 (Rev. 9/03) Madison County Sheriff's Office
Please print in ink (preferably black) or use typewriter Send this applicationAn Equal Opportunity Employer directly to the agency
Number of attachments announcing the vacancy.
Position number Application for Employment

Employees of the Commonwealth and applicants for employment As a means of accommodation to persons with specific
shall be afforded equal opportunity in all aspects of employment disabilities that prevent them from completing this application,
without regard to race, color, religion, political affiliation, national confidential assistance in filling out this application may be
origin, disability, marital status, gender or age. obtained by calling the agency to which you are applying.

1. Position applied for 2. Agency
(one per application)
(Note: Completion of number three is optional. Failure to submit social
3. Social Security No. security number on this form will not prohibit employment consideration.
Social security number may be required on other forms prior to employment.)

4. Full legal name 6. Home Phone ( )
Last F irst Middle
5. Address 7. Business Phone ( )

8. E-mail Address
City State Zip

9. EDUCATION
a. Check highest grade completed 1 2 3 4 5 6 7 8 9 10 11 12
b. If you did not complete high school, do you have a high school equivalency diploma? Yes No
c. Check number of years of post high school education 1 2 3 4 5 6 7

Name and Location of Institution Hrs Degree Major or Specialty Minor Dates Attended

Received
1.
2.
3.
d. If you expect to complete an educational program in the near future, please indicate what type of degree or program and expected
completion date:

10. EXPERIENCE — Use Supplementary Experience Form(s) for additional space. Starting with the most recent, describe ALL paid, military and applicable
voluntary experience. Highlight your knowledge, skills and abilities which best demonstrate your qualifications for this position.
You may list significantly different jobs within the same organization as separate items. May we contact your present supervisor? Yes No

a. Job Title Duties:

Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

b. Job Title Duties:
Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

c. Job Title Duties:
Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

d. Use this space for any additional information you think would help us evaluate your application, including training, seminars, workshops,
and special achievements or specialized skills:

e. Automated word processing (specify equipment)

Typing speed words per minute. Shorthand speed words per minute
f. License (to include driver’s), certificate or other authorization to practice a trade or profession.

Type License Number Granted by (licensing board)

11. REFERENCES
List names, addresses and relationships of three persons not related to you who know your qualifications:

Name Address Phone Relationship

12. MISCELLANEOUS
a. Check which shift you will accept: Day Evening Night Rotating Weekends Specify shift hours
b. Check which job status you will accept: Full-time Part-time (specify)
c. Check which employment status you will accept: Salaried (benefits) Hourly (No benefits) Part-time salaried (leave benefits only)
d. Are you willing to accept employment which requires you to travel? No Yes. If yes, During the day only,

Occasionally overnight, Frequently overnight.
e. List the geographic locations in which you are willing to work. If anywhere in Virginia, write “all”
f. Are you willing to provide your own transportation if necessary for your employment? Yes No.
g. For purposes of compliance with The Immigration Reform and Control Act, are you legally eligible for employment in the United States?

Yes No. Under the Immigration Reform and Control Act of 1986, you will be required to fill out a certification verifying that you
are eligible to be employed and verifying your identity. Further, you will be required to provide documentation to that effect should you be
employed.

h. Section 2.2-2804 of the Code of Virginia prohibits any board, commission, department, agency, institution or instrumentality of the
Commonwealth from employing a person who is required to present himself and submit to the federal Selective Service registration
requirement and failed to do so. If you are/were required to register for the Selective Service, have you done so? Yes No.
If no, state reason:

i. For purposes of compliance with Section 2.2-2903 of the Code of Virginia, are you a veteran who received an honorable discharge and has (i) provided
more than 180 consecutive days of full-time active- duty in the armed forces of the United States or reserve components thereof, including the National
the National Guard, or (ii) has a service-connected disability rating fixed by the United States Veterans Affairs?

Yes No. If yes, did you serve during the Vietnam Conflict (2/28/61-3/7/75)? Yes No
j. Have you ever been convicted* for any violation(s) of law, including moving traffic violations. Yes No If YES, please provide the following:

Description of offense:
Statute or ordinance (if known ): Date of Charge: ; Date of Conviction
County, City, State of Conviction:
(For additional convictions use plain paper. Include all information listed above.)

• Convictions include Virginia juvenile adjudications for Capital Murder, First and Second Degree Murder, Lynching, or Aggravated Malicious Wounding, if you were age

13. When will you be available to start work? (No date is necessary if you are available as soon as you give two (2) weeks notice.)
Month Day Year
14. CERTIFICATION-Each Application Requires Current Date and Original Signature

I hereby certify that all entries on both sides and attachments are true and complete, and I agree and understand that any falsification of information herein, regardless of
time of discovery, may cause forfeiture on my part of any employment in the service of the Commonwealth of Virginia. I understand that all information on this application
is subject to verification and I consent to criminal history background checks. I also consent that you may contact references, former employers and educational institutions
listed regarding this application. I further authorize the Commonwealth to rely upon and use, as it sees fit, any information received from such contacts. Information
contained on this application may be disseminated to other agencies, nongovernmental organizations or systems on a need-to-know basis for good cause shown as
determined by the agency head or designee.
Date Applicant Signature

DHRM Form 10-012A(Rev. 9/03) Attachment Number

Supplementary Experience Form

Social Security Number Position Applied For
Name Announcement Number



Job Title Duties:

Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

Job Title Duties:
Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

Job Title Duties:
Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

Job Title Duties:
Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

Job Title Duties:
Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

DHRM Form 10-012A(Rev 9/03) Attachment Number

Supplementary Experience Form

Social Security Number Position Applied For
Name Announcement Number



Job Title Duties:

Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

Job Title Duties:
Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

Job Title Duties:
Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

Job Title Duties:
Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

Job Title Duties:
Employer
Address

Phone

Type of business
Immediate supervisor

Title Number and titles of employees you supervised
Salary (start) (finish) Equipment used
Dates (mo/yr) to (mo/yr) Reason for leaving
Full-time Part-time Hours/week Your name if different from present

AUTHORIZATION FOR RELEASE OF INFORMATION

TO: ANY DOCTOR, HOSPITAL, MEDICAL ASSOCATION, U.S. ARMED FORCES, MARITIME SERVICE,
VETERANS ADMINISTRATION OR

ANY ACADEMIC DEAN, REGISTRAR, GUIDANCE COUNSELOR, OTHER AUTHORIZED PERSON AT A
SCHOOL, COLLEGE, BUSINESS, TRADE OR HIGH SCHOOL OR

ANY PAST OR PRESENT EMPLOYER, CREDIT BUREAU OR RETAIL MERCHANTS ASSOCIATION,
BANK FINANCIAL INSTITUTION OR ANY OTHER CREDIT AGENCY OR ANY OTHER STATE OR
FEDERAL AGENCY:

I, __________________________________________________________ (________________________)
Name Maiden Name

Address ______________________________________________________________________________
Street or Road City or Town State Zip Code

Have applied for employment with the Madison County Sheriff’s Office, and I am aware that my entire
background will be investigated. I hereby authorize and request the release of any and all information
you have concerning me (including a transcript of any academic records) to the Madison County Sheriff’s
Office or its agent upon presentation of this release or copy hereof.

I am further aware that this investigation may not begin or be concluded for an undetermined amount
of time after the execution of this document, and I authorize this document to be recognized as valid
until such time as my background investigation has been completed.

Armed Forces Services or Serial Number (if any) ________________________________________

Veterans Administration Claim Number (if any) _________________________________________

Social Security Number ____________________________________________________________

Given under my hand this________ day of _____________________________, 20_____________.

___________________________________
Signature (sign before notary only)

STATE OF VIRGINIA: COUNTY/CITY OF

This day__________________________________________personally appeared before me and
acknowledged his/her signature of the above statement.

My commission expires on the _______day of __________________________, 20____________.

__________________________________
Notary Public

RELEASE OF INFORMATION SUBJECT TO THIS AUTHORIZATION IS NOT IN CONFLICT WITH THE FAIR CREDIT REPORTING ACT,
PUBLIC LAW 91-508, NOR VIRGINIA STATUTES RELATING TO THE PRIVACY PROTECTION ACT.