Full Name*
Agency*
Division, Station or Area assigned to*
Address*
City*
State*
Zip Code*
SSN# or TAX ID#*
Include Dash (-)
Date of Birth*
Sex*
 Male
Female
Driver's License No#, State*
Home Phone#*
Cell Phone#*
E-mail*
Peace Officer*
 Active
Retired
California P.O.S.T. Certified*
 Yes
No
Military Police or Military Security D.O.D.
 Active
Retired
How many years as a Law Enforcement Officer?
Guard Card*
 Yes
No
Exposed Weapons Permit*
 Yes
No
Concealed Weapons Permit*
 Yes
No
Referred By?*

CONFIDENTIALITY
These documents are REQUIRED in order to establish validity of current position. ALL documents are kept under lock and key. These documents will never be released (unless in a court of law by subpoena or defense), NO EXCEPTIONS will be made. We do not verify employment with other companies due to the nature of our business. Therefore, if you are applying for credit or other employment elsewhere, we will not be able to verify your service with us. Please do not ask, as this is for your safety and security.


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