Fillable APPLICANT INFORMATION Full Date of Student S (Arapahoe Community College)

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APPLICANT INFORMATION Full Date of Student S (Arapahoe Community College)

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LAW ENFORCEMENT ACADEMY APPLICATION Date:
APPLICANT INFORMATION
Full
Name:
Last First Middle
Date
of
Birth:
Student
ID:
S
Address:
Street Apartment /Unit #
Home Phone:
City State ZIP
Mobile
Phone:
Email
Address:
EDUCATION
Hig
h School: From: To:
Address:
Did you graduate?
YES NO Diploma GED
College: From: To:
Address:
Did you graduate?
YES NO Degree:
Technical/Other:
From: To:
Address:
Did you graduate?
YES NO Degree:
Academy you are Applying for: Full Time
Fall
Spring
Year :
Part
Time
YES
NO
Driver’s License #
YES
NO
YES
NO
YES
NO
Refresher
Do you Have a Driver’s License?
Are you a citizen of the United States?
Have you ever been convicted of a Misdemeanor?
If yes, explain:
Have you ever been convicted of a Felony?
If yes, explain :
EMPLOYMENT HISTORY
Please provide employment history for the last five years or three jobs.
Company:
From:
To:
Address:
Phone: Supervisor:
Job Title:
Responsibilities:
Reason for Leaving:
May we contact your present/past employer for a reference?
YES NO
Company:
From:
To:
Address:
Phone: Supervisor:
Job Title:
Responsibilities:
Reason for Leaving:
May we contact your present/past employer for a reference?
YES NO
Company:
From:
To:
Address:
Phone: Supervisor:
Job Title:
Responsibilities:
Reason for Leaving:
May we contact your present/past employer for a reference?
YES NO
Have you ever been fired or asked to resign from any place of employment or position?
YES NO
If yes, explain :
MILITARY SERVICE
Branch:
From:
To:
Rank at
Discharge:
Type
of Discharge:
If other than honorable, explain:
While in the military were you the subject of any disciplinary action such as a Court-Martial?
YES NO
If yes, explain:
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to acceptance into the Arapahoe Community College Law Enforcement Academy, I
understand that false or misleading information in my application or interview my result in my release.
Signature:
Date:
click to sign
signature
click to edit
Form Two Page 1 6/7/2010
Academy Written Assignment
S
tudent Name: _______________________________ Date: ____________________
P
lease answer the following questions.
What makes a career in Law Enforcement attractive to you?
What area of the course of study at this Academy causes you the greatest concern?
O
ther than Law Enforcement, what other careers have you considered?
W
hat have you done to prepare yourself for the Academy?
W
hat factors would cause you to terminate the Academy?
Form Three Page 1 6/7/2010
Authorization To Release Student Records
Federal legislation, the Family Educational Rights and Privacy Act of
1974, prohibits Arapahoe Community College from providing
information unless we have a written authorization from you as a
student. If completed, the form below will provide the Arapahoe
Community College Law Enforcement Academy Staff with the
necessary authority to release necessary information to prospective
employers.
I, ________________________________, authorize the Faculty and Staff of
the Law Enforcement Academy at Arapahoe Community College to release to
any prospective law enforcement or government employer all information
regarding my training, performance, academic standing, and past records.
Student Signature: ___________________________ Date: __________
Student Name Printed: ___________________________________________
Form Four Page 1 6/7/2010
Academy Student Agreement
I, _________________________, do fully understand that this Academy is not a
regular college type course. I also understand that this Academy is run like most police
academies, “semi-military.” Acceptance into the academy program requires completion
of a background check. I understand that unresolved issues in my background, as
determined by the Director of the Academy Program, may require completion of a
psychological examination prior to admission in the Academy. This psychological
examination will be completed by a licensed psychologist selected by Arapahoe
Community College and will be conducted at Arapahoe Community College’s expense. If
this psychological examination determines that I am not a suitable law enforcement
candidate, I will not be allowed to enroll in the Academy and this decision will be final.
During the course of this Academy, I know that there are certain classes that I must
achieve a minimum score of 70%, 80%, or 90% in order to pass.
I am aware that this Law Enforcement Training Program has a fitness
component. In order to successfully complete this program, I must complete all
components of the program. Failure to complete any one component will result in me
being ineligible to take the State Standardized Test.
During the course of this Academy, I understand that I will be engaging in
activities that require a certain amount of risk, i.e., firearms training, pursuit driving, and
arrest control. I agree to abide by all safety rules and procedures set forth by Arapahoe
Community College. I understand that if I fail to abide by these safety rules, I may fail
the academy program. I accept the responsibility to notify the college faculty when
safety violations occur, and I release the college faculty and its employees from liability
for injuries that may occur as a result of my participation in these activities.
I also understand it is my responsibility to read and familiarize myself with the
academy policies and procedures, and if I have any questions regarding rules or
regulations in this Academy, I should ask my training advisors.
Student Signature: ______________________________ Date: _________________
Student Name Printed: ___________________________________________________
Witness: ______________________________________ Date: _________________
Form Five Page 1 6/7/2010
Academy Student Affirmation
Students are reminded that successful completion of the course does not
guarantee employment. Agencies differ in their requirements and hiring
procedures. Employers consider personal background history and physical
problems as well as other qualifiers.
Affirmation
1. I understand that there are certain minimal standards relative to
criminal or delinquent behavior, physical or mental attributes, as well
as certain other emotional behaviors and habits that must be met for
me to be employable in law enforcement. If I am unable to meet these
minimal standards, I understand that completion of any Law
Enforcement Academy may or may not affect my employability. I fully
accept the responsibility to identify these minimal employment
standards set by individual law enforcement agencies.
2. I understand that the Academy does not provide State Certification as
a law enforcement officer. In order to become state certified, I am
aware that I must pass the State Standardized Certification
Examination given by the Colorado Attorney General’s Office and the
P.O.S.T. Board.
Print Student Name: __________________________________________
Student Signature: ____________________________________________
Date: ________________
Form Nine Page 1 7/23/2010
Academy Firearms and Weapons Policy Student
Acknowledge Form
Student Name Printed: _______________________________________
Student Identification Number: ________________________________
Firearms and Ammunition
1. All firearms and ammunition will be stored by Academy
personnel.
2. Unless specifically authorized, recruits SHALL NOT carry or
possess weapons, concealed or otherwise, while attending
the Arapahoe Community College Law Enforcement
Academy program classes, facilities or grounds.
3. Absolutely no unauthorized display of ANY firearm, baton, or
handcuffs will be tolerated.
4. Violation of this policy renders the recruit libel to
IMMEDIATE REMOVAL from the Academy Classroom and
subject to the Student Grievance procedure.
I have read the above section from the Arapahoe Community College Law
Enforcement Academy Policies and Procedures Manual. I have been given the
opportunity to discuss this policy with a Faculty member and I understand the
policy.
I will comply with the policy at all times.
Student Signature: ________________________________
Date: ________________
Form Seven Page 1 6/7/2010
Personal Data and Emergency Contact Sheet
Please provide us with the information below. The information provided in this form will be
used for your Law Enforcement Academy class call list. Emergency contact information is for
Law Enforcement Academy staff and instructors only.
Please indicate in the column to the left which phone number you prefer to be used to contact
you.
Name:
Mailing Address:
City, State, Zip:
Home Phone:
Cell Phone:
Home Email:
Emergency Contact Information:
Primary Contact Info
Secondary Contact Info
Name:
Relationship:
Home Phone:
Cell Phone:
Doctor’s Name:
Doctor’s Phone:
Hospital Preference:
Allergies/Health Problems
that should be noted:
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APPLICANT INFORMATION Full Date of Student S (Arapahoe Community College)

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Completed 6 September 2020

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