Junior Deputy Program Application

Fulton County Sheriff's Office Junior Deputy Leadership Academy

Please fill this form out completely.
Student’s Name*

First NameMiddle InitialLast Name
Student's Date of birth*

MonthDayYear
Student's Current Age
Student's Gender*
Student's Shirt Size? (ex. Youth Med, Adult Large, ect.)
Student’s Current School Name*
Student’s Current Grade Level*
Student's Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does Student Have Any Allergies or Special Needs? Please Specify, if so...
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email Address*
example@example.com
Parent's Phone Number*
Format: (000) 000-0000.
Parent's Secondary Phone Number
Format: (000) 000-0000.
Parent's Secondary E-mail
example@example.com
The Junior Deputy Leadership Academy will be June 8th through June 12th from 8:30 AM to 4:30 PM at The Fulton County Sheriff's Office (185 Central Ave, 9th Floor, Atlanta, Ga 30303).

Students must be between the ages of 11-17 years old.

If you have any questions regarding the Junior Deputy Leadership Academy, please contact Sgt. C. Bynum at (678) 296-1535 or via email at Chelsea.Bynum@fultoncountyga.gov
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Fulton County Sheriff's Office Junior Deputy Leadership Academy