Full Legal Name
*
First Name
Last Name
Email Address
*
Confirmation Email
example@example.com
Mobile Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Current Stage
Case Status
Lead Readiness
Eligibility Status
Payment Status
Payment Amount
Payment Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Payment Method
Eligibility Review Fee Type
Please Select
Standard $195
Former Florida $45
Other
Waived
Assigned Staff Member
Date Intake Received
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Customer Contact Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Next Follow-Up Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Follow-Up Priority
Please Select
Normal
High
Urgent
Customer Service Notes
Missing Documents / Due-Outs
Stage 2 File Opened
No
Yes
Stage 2 File Opened Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Documentation Packet Status
Please Select
Not Started
Sent
Partially Received
Complete
Eligibility Decision
Please Select
Pending
Eligible
Not Eligible
Needs More Information
CJSTC Form 76 Status
Please Select
Not Started
Processing
Issued
Obtained at Another Selection Center
Expired
CJSTC Form 76 Issued Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
CJSTC Form 76 Expiration Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
EOT Registration Status
Please Select
Not Ready
Ready to Register
Registered
Waitlisted
Course Complete
SOCE Status
Please Select
Not Ready
Eligible to Test
Scheduled
Passed
Failed Attempt 1
Failed Attempt 2
Failed Attempt 3
Employment Status
Please Select
Unknown
Seeking Employment
Processing with Agency
Hired
Agency / Employer
Case Closed
No
Yes
Case Closed Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Case Closure Reason
Select Your Certification Pathway
*
Out-of-State Law Enforcement / Corrections
Federal Law Enforcement / Corrections
U.S. Military Police
Special Operations Forces
Previously Florida Certified Officer
Not Sure / Help Me Choose
What is the name of your qualifying agency?
*
Referral Code or Name of Referring Agency / Recruiter / Candidate
Which state, territory, or area is your qualifying agency located?
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
U.S. Virgin Islands
Guam
American Samoa
Northern Mariana Islands
Other U.S. Territory
Outside the United States / Other
Select the state or territory where your qualifying agency or duty location is based. Federal applicants should select the state of their current or most recent qualifying duty station. Military applicants should select the state or territory of their current or most recent qualifying duty location. If your qualifying duty location was outside the United States, select Outside the United States / Other.
I understand this Stage 1 Interest List creates a GovSource EOT case for follow-up but does not determine final eligibility or guarantee issuance of CJSTC Form 76.
*
Acknowledged
How did you hear about GovSource?
*
Please Select
Referred by a law enforcement agency or recruiter
Referred by another EOT candidate
GovSource website
Google / Search Engine
Facebook
Instagram
LinkedIn
Conference / Recruiting Event
Training Academy / College
Employer / Agency
Word of Mouth
Other
Are you ready to open your formal Form 76 eligibility review file and pay the applicable review fee?
*
Please Select
Yes — I am ready to open my file and pay now
Maybe — I need more information before paying
Not yet — please keep me updated
What questions can the GovSource EOT team help you with?
Join EOT Interest List
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