Lake County Sheriff's Office - Sheriff's Academy Program

Lake County Sheriff's Office
Lake County, Florida

Sheriff's Citizen Academy Program

Name:		Social Security#:
FL Driver's License#:		Date of Birth:
Home#:		Cell#:
Email:
Current Address:			How long?
Previous Address:
Occupation(past and present):

Have you ever been convicted of any offense, other than traffic?:
Yes No If yes, what for? (include when and where)


Would you be able to attend all the sessions? Yes No

How did you hear about the Sheriff's Academy?

	What do you expect to gain from attending this Academy?

	Please list names and addresses of two character references not related to you:


By checking the following box, I hereby certify that the information in this application is true and complete to the best of my knowledge. You are hereby authorized to make an investigation of my personal history deemed necessary for consideration to attend the Sheriff's Academy.