Application for Funding Assistance to Attend ARIDE
To be completed by a supervisor of the prospective student
Applicant Name
*
Title
First Name
Last Name
Agency Name
*
Applicant E-mail
*
example@example.com
Agency Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Information Relating to Your Agency
Number of Full Time Officers
Number of Part Time Officers
Total Individuals arrested by your agency for impaired driving (alcohol or other drugs)
Information Relating to the Prospective Student
Prospective Student Name
Title
First Name
Last Name
Prospective Student E-mail
example@example.com
Years of Law Enforcement Service
Month & Year of Last SFST Refresher
Date and Location of ARIDE Training
Total Individuals arrested by the prospective student for impaired driving (alcohol or other drugs)
Submit Application
Should be Empty: