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Please complete STEPS 1-5 on page 1, one week or more
before scheduling an appointment to turn in TCOLE
application.
TCOLE Basic Peace Officer Jailer Requirement’s
1: L1 form Law Enforcement Agency Audit Checklist:
• Signed by your chief and Notarized.
• (Form attached to email)
• Valid Texas Driver’s License
• Jailer Credentials
• Auto insurance card
2: Please read the 217.1 Tcole rules
• sign and turned in 217.1
Acknowledgement
• (Form attached to email)
3: C-1 Form
• Please sign and turn in C-1 Form
• (Form attached to email)
4: Authorization of Medical Records
• Please sign and turn in Authorization of Medical
Records
• (Form attached to email)
AGF 03.001 Law Enforcement Agency Audit Checklist 4.30.2018
TEXAS COMMISSION ON LAW ENFORCEMENT
6330 East Highway 290, STE., 200, Austin, Texas 78723-1035
Phone: (512) 936-7700
www.tcole.texas.gov
Law Enforcement Agency Audit Checklist
All Licenses - Peace Officer, Jailer, Telecommunicator
Employee Name:
PID Number:
Appointed to agency prior to 4.15.1996. Prior to this date TCOLE kept all required documentation for appointment on file
in Austin; current firearms qualification is the only document required for individuals hired prior to that date.
New License
§217.1
180 Days or Less Break in Service
§217.7
More Than 180 Day Break in Service
§217.7
L-1 / L1-T (sign & notarize page 1 & 2)
F5R (required only for appointments after
9.01.05, if the applicant had another license
type – peace officer, jailer, TCO)
L-2 (drug screen/ medical exam)
(Telecommunicators- drug screen only)
L-3 (psychological evaluation)
CCH (TCIC-NCIC)
DPS/FBI Fingerprint Return**
Proof of Citizenship (Effective 3.01.03)
Proof of Education - HS Diploma
(accredited) or GED
Military Discharge (if applicable)
Personal History Statement (Effective
1.01.12)
Certified Copy of Court Disposition ***
For peace officers only- Current record
of firearms qualification (once per
calendar year). Does NOT apply to
1
st
appointment of BPOC graduates.
L-1 / L1-T
(sign & notarize page one only)
F-5R (required only for appointments
after 9.01.05)
CCH (TCIC-NCIC)
Certified Copy of Court Disposition ***
Military Discharge (if applicable)
Personal History Statement (Effective
1.1.12)
For peace officers only- current
record of firearms qualification (once
per calendar year).
L-1 / L1-T (sign & notarize page 1 & 2)
L-2 (drug screen )
L-3 (psychological evaluation)
F-5R
(required only for appointments
after 9.01.05)
CCH (TCIC-NCIC)
DPS/FBI Fingerprint Return**
Military Discharge (if applicable)
Personal History Statement (Effective
1.01.12)
Certified Copy of Court Disposition ***
For peace officers only-
current record of
firearms qualification (once per calendar
year).
All documentation must be in place prior to submitting the L1 appointment form. Failure to complete
and document the pre-licensing requirements above is a violation of state law and may result in
penalties ranging from fines (up to $1,000 per day, per incident) to criminal charges (State Jail felony
for appointment of a person with a criminal record). Texas Occupations Code 1701.507 and 1701.553.
**Fingerprint returns can be obtained by: a) mailing a 10-print applicant card to DPS, b) using the
F.A.S.T. electronic fingerprint service, c) using an agency’s Live Scan provided it has been
validated/approved by DPS for applicant processing. To set up a F.A.S.T. account, please contact DPS
at 512-424-2365, choose option 6. To validate your agency’s Live Scan contact DPS at 512-424-2409.
***For all charges class B and above or class C involving family violence or official duties.
IMPORTANT: TCOLE REQUIRED DOCUMENTS SHOULD BE KEPT TOGETHER IN A SECURE BUT
EASILY-ACCESSIBLE FOLDER
SEPARATE FROM PERSONNEL FILES AND OTHER DOCUMENTS.
---CONTACT YOUR TCOLE FIELD AGENT IF YOU NEED MORE INFORMATION---
ATP 15.002 Declaration of Licensing Course Enrollment Eligibility 2.7.2019 Page 1 of 1
DECLARATION OF LICENSING COURSE ENROLLMENT ELIGIBILITY
Texas Commission on Law Enforcement (TCOLE) Rule 217.1 requires a training provider to have on file (on or before
the first day of the licensing course) documented proof that the student meets all eligibility requirements for licensure.
Training providers conducting licensing courses for either their own personnel or independent students (not hired by an
agency) must have all required documents on file and readily available for review. Training providers conducting
licensing courses for personnel from other Law Enforcement agencies may, with the advice and consent of their
Advisory Board, either maintain copies of the required documents from the employing agency or use this declaration
document as proof of compliance with Rule 217.1.
TRAINING ACADEMY: _____________________________________________________ ACADEMY #: ____________________
EMPLOYING/APPOINTING AGENCY: _________________________________________________________________________
TRAINEE’s NAME: __________________________________________________________________ PID #: ________________
The above-named person (check one): ☐ is currently hired as a police cadet; ☐ is currently hired as a
telecommunicator or jailer, and 1) has a temporary license, or 2) does not have a temporary license solely due to
Occupations Code 1701.310(b) ☐ is currently licensed and hired by this agency as a peace officer, telecommunicator
or jailer and seeking an additional licensed position within this agency. Furthermore, our agency already has on file
documented proof that the above-mentioned individual meets all the minimum eligibility requirements for the license
being sought (must attach completed TCOLE Law Enforcement Agency Checklist).
HIRING AGENCY ADMINISTRATOR SIGNATURE SECTION (Must be completed and signed by the agency head or designee.)
As head of the agency, or his/her designated representative, I am endorsing this official government record which
certifies, subject to civil and criminal penalties, it has been completely filled out with true and correct information. I also
attest that the applicant has met all the requirements for enrollment and licensure as required by Commission Rule
217.1 without exception. Our agency shall provide copies of all required eligibility documents to the enrolling academy
or TCOLE representatives upon request.
__________________________________________ ___________________________________ _________
Printed Chief Administrator’s (or designee) Name & Title Signature of Administrator (or designee) Date
State of Texas
County of ______________________ Sworn and subscribed before me, this the ____ day of ____________________, 20_____
Notary public in and for the State of Texas.
My commission expires ____/_____/_____ ________________________________ ______________
Notary Public's Signature Notary stamp/seal
APPLICANT SIGNATURE SECTION (This section must be completed and signed by the trainee.)
As the trainee, I am endorsing this official government record to certify, subject to civil and criminal penalties, that all its
contents are true and correct. I also confirm that I currently meet all the requirements for enrollment as required by
Commission Rule 217.1 without exception.
__________________________________________ ___________________________________ _________
Printed Applicant’s Name Signature of Applicant Date
State of Texas
County of ______________________ Sworn and subscribed before me, this the ____ day of ____________________, 20_____
Notary public in and for State of Texas.
My commission expires ____/_____/_____ ________________________________ ______________
Notary Public's Signature Notary stamp/seal
LE-511246
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Protective Services - Law Enforcement Academy
Page 1 of 1 Revision date: Nov 2017
Authorization for Medical Records
Date
I hereby authorize release of information permitted by law on my physical exam and
drug screen to the party named below.
I, the Undersigned, authorize any physician or nurse who has attended me, or any
hospital at which I have been confined, to furnish SAN ANTONIO COLLEGE LAW
ENFORCEMENT TRAINING ACADEMY, any and all information which maybe
requested regarding my physical condition, and if necessary, to allow them or any
physician appointed by them to examine any X-ray pictures or other radiological
procedures taken of me or records regarding my physical condition as related to my
physical exam and drug screen.
A Photostatic copy of this authorization is to be given the same force and affect as
the original.
SIGNED (LEGAL SIGNATURE) Date
Name (Please Print) Witness
Address Date
City State Zip Code
Protective Services - Law Enforcement Academy
Student Consent Statement and Waiver
Name: _
(Please Print)
D.O.B.
Driver’s License/I.D. _ Phone Number: ( _)
(State) (Number)
Address: _
(Street Number) (City) (State) (Zip Code)
PERSON TO NOTIFY IN CASE OF AN EMERGENCY:
Name: _
Phone Number: ( ) _
PLEASE INITIAL THE YES/NO
BLA
NKS
.
1. I have voluntarily enrolled in the Basic Peace Officer training program provided by the Law Enforcement
Training Academy, San Antonio College on May 04 2020 date.
Yes
No
2. I understand that the Public Safety field, specifically Law Enforcement, is potentially dangerous and that
there is a real risk of injury or death.
Yes
No
3. I understand that the training I receive at the Law Enforcement Training Academy is intended to
increase skill competencies that will serve to reduce the risks associated with a high risk environment. Yes
No
4. I understand that although the training methodologies have been designed to produce a safe training
environment, it would be unrealistic to think or expect that every aspect of training is risk free.
Yes
No
5. I understand that the risks associated with this training potentially range from minor injuries, including,
but not limited to, pulled muscles, bruises, sprains, and lacerations to serious injury, such as broken bones,
gunshot wounds and even death.
Yes
No
6. I agree to report any pre-existing injury or condition to my instructor prior to any physical activity or
training.
Yes
No
7. I understand that there will be physical activities and contact with other students and/or instructors and
such activities and contact are necessary to provide realistic training.
Yes
No
Protective Services - Law Enforcement Academy
Student Consent Statement and Waiver
8. I understand that I will be exposed to graphic language which is intended to add realism to the training,
as
well as condition and prepare me for a “real world” environment and the “Police Culture”.
Yes
No
9. I
am
in
good
physical
health/condition. Yes
No
If
No,
explain:
10.
I understand that if I have indicated “No” in item number (9) that I may be required to submit a m
edical
release from a physician stating any specific limitations and that I am able to participate in the required
training.
Yes
No
11. I
am
between
the
ages
of
20
and
65. Yes
No
12. I understand that my enrollment and participation in the Basic Peace Officer’s Course is strictly
vol
untary and that I am able to withdraw from the course at any
time.
Yes
No
13. I agree to allow my name and grades/grade average to be publicly posted within the class rooms and
m
ain lobby of the Law Enforcement Training Academy by the Course
Instructor/Academy
Director.
Yes
No
EXPRESS
WA
IVER
I voluntarily accept the risks associated with the
Basic Peace Officer’s Course and agree to waive any action, to include any action by my heirs and
assignees, for injuries or damages occurring during the normal course of legitimate training against the
Law Enforcement Training Academy, San Antonio College, their employees, or any other person
participating in the Basic Peace Officer’s Course.
STUDENT
CERTIFICA
TION
I certify that I have read this informed consent statement and waiver in its entirety and that I have truthfully
answered all questions contained in the document.
(Signature)
(Witness Name) (P
lease Print) (Date)
_
(Witness Signature)
TEXAS COMMISSION ON LAW ENFORCEMENT
6330 E Highway 290, STE 200, Austin, Texas 78723-1035
Phone: (512) 936-7700
http://www.tcole.texas.gov
PID ASSIGNMENT (C-1)
Completion of all fields required.
INDIVIDUAL INFORMATION
1. Social Security Number
2. First Name
3. M.I.
4. Last Name
5. Suffix (Jr., etc.)
6. Race / Ethnicity
American Indian or Alaskan Native Asian
Black Hispanic Multicultural White
7. Date of Birth
/ /
8. Gender
Male
Female
9. Driver’s License
State:
Num.:
10. Home Mailing Address
11. City
12. State
13. Zip Code
14. Height
15. Weight
16. Hair Color
17. Eye Color
18. U.S. Citizen
Yes No
19. Phone Number (include area code)
20. Email
This form is to be submitted only for the express purpose of having a personal identification number (PID) assigned by
TCOLE to the above named individual therein creating a TCOLE record and allowing training to be reported for that
individual.
Agency administrator or training coordinator check appropriate box for their student or employee.
Applying for entry into a basic licensing course.
Applicant has read and received a copy of §217.1 Minimum Standards for Initial Licensure.
_____________________________________________
___________________________
Signature of Applicant Date
Future appointment as a Telecommunicator, Temporary or Licensed
Future appointment as a County or Contract Jailer, Temporary or Licensed
Future Appointment as a Probation Officer, Juvenile or Adult
Ability to track training hours
TCOLE agency / training provider number ________ and Name __________________________________________
_____________________________________________
___________________________________________________________________________
Agency Administrator or Training Coordinator (Type or Print) Signature Date
Individuals not associated with a training provider or agency check below.
Applying for instructors certificate
Applying for Retired Federal Firearms ID
Applying for consideration of prior out-of-state, federal, military, special forces or TDCJ training.
Signature of Applicant Date
PID Assignment 11.18.2015 Page 1 of 1
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