Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Programs You Are Interested In
*
Chaplain
Citizen Observer Patrol
Mounted Posse
Police Athletic League
Victim's Services
Are you a United States citizen?
*
Yes
No
Do you have a valid Florida driver’s license?
*
Yes
No
Level of education
*
Please Select
Less than High School
High School Diploma
Trade/ Technical/ Vocational
Associate Degree
Bachelor's Degree
Postgraduate Degree
Other
Do you have any felony convictions or misdemeanor convictions involving moral character or false statements?
*
Yes
No
I would like to receive updates and communications from the sheriff's office
Opt-in to communications
I certify that I am of good moral character and have no felony convictions or misdemeanor convictions involving moral character or false statements.
*
I certify that I am of good moral character and have no felony convictions or misdemeanor convictions involving moral character or false statements.
Electronic Signature
*
Please verify that you are human
*
Submit Application
Submit Application
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