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Welcome to SRSU H. Joaquin Law Enforcement Academy
Academy Interest and Initial Screening Form
37
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1
General Information About the Form
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State law and Texas Commission on Law Enforcement regulations require all persons attending Texas police academies to pass a background investigation. The following questions are for initial screening purposes ONLY. All of your responses will be verified, so it is imperative you answer honestly. (Print "I understand" in the box below, please)
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2
I have read all of the information above and understand the content.
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3
I have read the TCOLE rules and attest that I meet the minimum requirements for licensing listed therein
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For TCOLE requirements visit TCOLE website (Texas Administrative Code RULE §217.1)
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4
Can you prove you are a United States Citizen?
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5
Do you have a high school diploma or a GED?
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6
Do you satisfy the following TSIA requirements?
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The cadets must satisfy Texas Success Initiative (TSI) Assessment requirements, unless they qualify for a TSI exemptions, exceptions, and waivers (see Texas Administrative Code, Title 19, Part 1, Chapter 4, Subchapter C, Rule 4.54). The TSIA test passing standards for the academy are as follow: Reading 351; and Writing: 1. a placement score of at least 340, and an essay score of at least 4; or 2. a placement score of less than 340 and an ABE Diagnostic level of at least 4 and an essay score of at least 5.
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7
Are you currently attending college?
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8
Do you have a college degree?
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9
Do you meet the age requirements as outlined above, or will you meet those requirements at the time of completion of the academy
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10
Have you ever been arrested for an offense other than traffic offenses?
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11
Have you ever been convicted, received probation or deferred adjudication for a Class A misdemeanor or a felony under the Penal Code or equivalent under federal law or law in other states, to include the Uniform Code of Military Justice (UCMJ)?
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12
At any time, have you ever been convicted for any assaultive offense including family violence?
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13
Have you ever been convicted, received probation or deferred adjudication for a Class B misdemeanor under the Penal Code or equivalent under federal law or law in other states, to include the Uniform Code of Military Justice (UCMJ) in the last ten (10) years?
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14
Do you have any pending criminal charges or indictments for any criminal offense?
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15
Are you able to perform the required academic testing and physical training?
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16
Have you ever illegally sold, produced, cultivated, or transported for sale marijuana?
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17
Have you illegally used marijuana for any purpose within the past year?
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18
Have your ever illegally used marijuana other than for experimentation?
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19
Have you ever illegally sold, produced, cultivated, or transported for sale a dangerous drug or narcotic
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20
Have you ever illegally used a dangerous drug or narcotic, other than marijuana, for any purpose within the past seven years?
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21
Have you ever illegally used a dangerous drug or narcotic other than for experimentation?
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22
Do you have a pattern of abuse of prescription medication?
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23
Have you ever willfully provided false information in connection with application to this academy, any other police academy, or any application for employment?
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24
Have you ever committed a felony, an offense that would be a felony if committed in this state, or an offense involving dishonesty, unlawful sexual conduct, or physical violence?
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25
Do you currently have a medical, physical, or mental disability that substantially limits the person's ability to perform the duties of a peace officer effectively, or may create a reasonable probability of substantial harm to the person or others, for which a reasonable accommodation cannot be made?
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26
Have you ever committed malfeasance, misfeasance, or nonfeasance in office?
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27
Have you ever engaged in any conduct or pattern of conduct that would tend to disrupt, diminish, or otherwise jeopardize public trust in the law enforcement profession?
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28
Have you ever been terminated or resigned in lieu of termination from any employment for inefficiency, delinquency, or misconduct?
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29
Have you ever made false statements, withheld information, included deceptive or fraudulent information on any application for employment, Personal History Statement, medical, or psychological exams?
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30
Have you ever attended (even if you did not graduate) a basic peace officer course?
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31
Are you currently, or have you ever been, a member of any organization which advocates the overthrow of the government?
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32
Have you been discharged from the military with anything other than "Honorable"?
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33
How many traffic-related at-fault accidents have you had in the last 5 years?
Please enter a number
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34
How many jobs have you had in the last 5 years?
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Please enter a number
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35
How many traffic citations for moving violations have you received in the past 5 years?
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Please enter a number
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36
Certification : I understand each question as written.
The above is true and correct to the best of my knowledge. I understand that if I chose to formally apply for the academy, the above answers will be verified and a complete background investigation about me will be done. I agree to both verification of my responses and the background investigation.
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Applicant name
Date
Address, City, State, Zipcode:
Please enter your email
Please enter your phone with area code
DOB: Gender: Race:
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37
Applicant Signature
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Write Your Name
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