47th Cadet Lawman Registration Form

47th Annual

Cadet Lawman Academy Application

SPONSORED BY

The Oklahoma Highway Patrol
and
The Oklahoma Elks Major Projects
and
The Oklahoma State Troopers Association
and
CUDD Pressure Control

June 6, 2021 - June 12, 2021

Warner, Oklahoma
Campus of Connors State College

Application deadline April 1st, 2021

If you have any questions, please contact us at:
405-295-5001 or cadetlawman@gmail.com
Online Cadet Lawman Academy application process

1. Verify you are eligible for the academy. Confirm you have no scheduling conflicts.

2. Complete the following online registration form.
a. Upload a current photo (headshot like on a drivers license) in the space provided.
b. Upload a current athletic physical.
(Upload photo and physical now or Submit via email or mail with other documents later.)

3. Verify your information is correct and submit the online application.

4. You will receive a registration confirmation with a link to the "Endorsement Section".
a. Print the "Endorsement Section" form.
b. Obtain the required endorsements.
c. Submit that completed form via e-mail or mail by April 1, 2021
Requirements and Elgibility:

1. Applicant must live in Oklahoma.
2. Applicant completes the application.
3. Applicant must be a junior in high school or home school.
4. Grade point average of 2.0 or higher.
5. Physically able to compete in all activities during the week long program.
6. Submit physical with doctor’s approval of their physical condition.
7. Recent picture of the applicant (passport size).
8. Signed endorsement from the high school principal or superintendent.
9. Signed endorsement from an Oklahoma Elks Lodge President or designee.
10. Signed endorsement from an Oklahoma Highway Patrol Trooper.
11. Applicant must believe in the Elks principles of law and order, and service to God and humanity.
12. The application must be completed in full to be eligible for consideration.
13. SUBMITTED BY APRIL 1, 2021.
APPLICANT INFORMATION:
Name*

First NameMiddle NameLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Birth Date*

MonthDayYear
Driver License #
Include the letter with the DL number.
Cell Number
E-mail*

Confirmation Email
Activities (School, Church, Sports, Clubs)*
T-Shirt Size*
Gender*

MaleFemale
Height*
Weight*
SCHOOL INFORMATION:
High School Name*
High School Town*
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*
Parent/Guardian E-mail

Confirmation Email
MEDICAL INFORMATION
Physician Name

First NameLast Name
Office Phone Number
Allergies*

NoneYes
Allergies (List all to include food, meds, other)*
Medical Concerns (Anything NOT listed on Physical Form)
APPLICATIONS CANNOT BE ACCEPTED WITHOUT HEALTH INSURANCE INFORMATION.
Name of Health Insurance Company*
Policy Number*
UPLOADS

Upload a recent photo and physical or mail them in to complete the application.
Photo of Applicant (upload head shot of applicant)

Upload a File
If unable to attach, email photo seperately. Cancelof
Upload physical now or Submit via email or mail with other documents later.

Upload a File

Cancelof
Applicants will submit a doctor’s approval of their physical condition. (Please note: An athletic physical completed on or after July 1, 2020 will be accepted. Any changes in your health since your athletic physical, must be noted and received prior to your attendance at the academy).
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APPLICANT INFORMATION:

SCHOOL INFORMATION:

PARENT/GUARDIAN INFORMATION:

MEDICAL INFORMATION

UPLOADS