OTSEGO COUNTY

LAW ENFORCEMENT ACADEMY


 

 

University Police Department                                                         DIRECTOR

Alumni Hall                                                            Lieutenant Jonathan D. Bartlett

State University of New York                                                          ADVISORS

Oneonta, NY  13820                                                  Sheriff Richard Devlin, Jr.

(607)436-3550                                                              Chief Barton R. Ingersoll

(607)436-2402 fax                                                         

                                                                                                                                                                                   

 

ENROLLMENT REGISTRATION FORM


COURSE TITLE  
OFFICER'S NAME  
OFFICER'S ADDRESS  
 
HOME PHONE NUMBER  
CELL PHONE NUMBER  
DATE OF BIRTH  
PERSONAL EMAIL ADDRESS
DEPARTMENT'S DCJS #  
EMPLOYING AGENCY  
DEPARTMENT PHONE NUMBER  

HEALTH INFORMATION:
All enrolling officers in a Basic Training/Advanced Course must provide proof of his/her physical condition, giving the immediate physical condition and being able to meet rigorous training requirements during the school duration.  All information therein will remain confidential.  A medical note is not required for all training classes.

EQUIPMENT INFORMATION:
All officers enrolling in the academy must supply all their needed supplies for classroom and field activities.  All officers must meet the dress code, uniform or casual business attire.  All officers must supply all ammunition and safety equipment for firearms.  A car must be provided for all EVOC courses.

RULES OF CONDUCT:
I agree to adhere to the official RULES OF CONDUCT approved by the Academy.  Any misconduct will not be tolerated and will result in the immediate dismissal from the program.

DEPARTMENT HEADS PLEASE COMPLETE:  I duly authorized him/her to attend the above referenced training course on behalf of the department, and that this department accepts responsibility for any and all actions of the member listed and will assume the burden of responsibility for any and all damages caused by the cadet.

Signature of Department Head _____________________________________

Title ___________________________________________________________

Date ______________________________