LEMA Honor Guard Application

Honor Guard Application
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Employing Agency and Agency's Address
Agency Phone Number

Area CodePhone Number
YesNo
How many years have you been a peace officer? With your present agency? If you have worked for another police agency, in any position, other than your present employer, please list:
YesNo
If yes, Branch, highest rank obtained, and specialization?
YesNo
If yes, please give details including when, where, what type of duties, etc.
Please provide your height and weight
YesNo
YesNo
YesNo
YesNo
If yes, please describe and list how many hours per week it involves:
Please list three persons, not related to you, who would be willing to provide a letter of reference on your behalf. These may include fellow officers, supervisors, or friends.

Please use the space below to provide any additional information you feel would be helpful
Upload any additional documents, such as resume here (optional)

Browse Files

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I certify by my signature that the information supplied on this application, along with any additional materials submitted are true and correct to the best of my knowledge.
Date

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Date
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