Lake County Sheriff's Office - Volunteer Program V.I.S.I.O.N.

Lake County Sheriff's Office
Lake County, Florida

Volunteer Program V.I.S.I.O.N.

Name:			Social Security#:
FL Driver's License#:			Date of Birth:
Address:			Telephone#: Email:
Physical Address:(If Different)
Occupation(past and present):
Highest Education completed:
Special Skills/Interests/ Certifications:
Additional Languages:
Have you ever been arrested:	Yes	No	If yes, was it a misdemeanor or felony charge? Explain:

What months are you available:
What days and times are you available:
Emergency Contact Name:			Relationship:
Address:			Phone #:
	What do you expect to gain from volunteering with the Lake County Sheriff's Office?

	Please list names and addresses of three 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 volunteer with the Lake County Sheriff's Office. Check Here:
LAKE COUNTY SHERIFF'S OFFICE AUTOMATIC DISQUALIFIERS The Lake County Sheriff's Office will automatically disqualify any individual who has at any time: 1. Been convicted of a felony or any offense that would be a felony if committed in the state of Florida. 2. Used (tried) any illegal narcotics in the past twelve months. 3. Sold illegal narcotics. 4. Been dishonorably discharged from the U. S. Armed Forces. 5. Had a pattern of abusing prescription medication. 6. Had excessive traffic violations within the past three years. 7. Lied during any part of the volunteer selection process. 8. Falsified his or her questionnaire or application. DISCRETIONARY DISQUALIFIER The following disqualifiers may, upon review, make you ineligible for volunteer service with the Lake County Sheriff's Office 1. A physical or mental disability that would substantially impair an individual's ability to perform his or her duties. 2. Alcohol misuse or abuse. 3. Inappropriate sexual conduct 4. Excessive traffic violations 5. Any household or immediate family member being convicted of illegal use of narcotics or of a felony offence. 6. Debts - a demonstrated unwillingness to honor fiscal responsibilities. 7. Any other conduct or pattern of conduct that would tend to disrupt, diminish, or otherwise jeopardize public trust in the law enforcement profession. By checking the following box, I have read and understand the above disqualifiers Check Here: