BASIC LAW ENFORCEMENT ACADEMY
REQUIREMENT CHECK LIST
Please contact the Coordinator at the campus where you intend to apply PRIOR to starting this process.
Key West Coordinator - Christine Collins - 305-809-3231
Upper Keys Coordinator - Liz Ruano - 305-809-3158
□ Psychological Test ($250) Begin this process by scheduling an appointment with:
Keys Psychological Testing Services (testing at FKCC Main and/or Upper Keys Campuses)
□ Polygraph Test ($150)
Begin this process by scheduling an appointment with:
Bruce Winegarden for Polygraph (located in the Middle Keys) by calling (305) 797-0014
□ Criminal Justice Basic Abilities Test (CJBAT) ($45)
To schedule test: Call 305-809-3185
Check or money order payable the day of test. Attach test results to application. (Valid FBAT scores also accepted)
□ Physical Fitness Assessment (CJSTC Form 75B, Last two pages of application) http://www.fdle.state.fl.us/Content/getdoc/3326bef8-7c10-4c00-96ed-998961d21963/CJSTC-075BDTD110807.aspx
□ FKCC Application for Admission. ($30) Apply & Pay online at www.fkcc.edu. Under degree area, check the box for PSAV major
and enter code 620) Provide a copy of the completed signature page and/or other printable documents required with the application.
□ Proof of FL Residency: Please provide copies of the following: (Unless exempt due to active duty military status, then provide current valid DL only)
□ Copy of valid FL Driver’s License (Must have been issued at least 12 months prior to the start date of the academy)
□ Vehicle registration (Must be dated at least 12 months prior to the start date of the academy)
□ Voter’s Registration Card (Must be dated at least 12 months prior to the start date of the academy)
□ Copy of High School Diploma or GED Certificate AND Sealed Official Transcript
□ College Transcript (If attended, must be Sealed/Official transcripts) KEY WEST mailing address: FKCC, Institute for Public Safety, 5901 College Road, Key West, FL 33040
UPPER KEYS mailing address: FKCC, Institute for Public Safety, 89901 US Highway 1, Tavernier, FL 33070
□ Application for Admission to Institute for Public Safety (Notarized)
□ Firearms Affidavit (Notarized)
□ Copy of Military Discharge (If applicable, Form DD 214)
□ Fingerprints (48.50, cash only) Must be done at Monroe County Sheriff’s Office in Key West, Marathon, or Tavernier. Use FKCC Law Enforcement Training Academy ORI# FL922240Z.
□ Copy of Proof of Citizenship (Birth Certificate or Certificate of Naturalization)
□ Copy of Social Security Card
□ Driving Record (7-year Driving History) (See page 7 on how to request a copy)
□ One RECENT 2” x 2” full-color, head and shoulders passport photo (For background purposes only)
□ Completed Financial Aid Form: FAFSA (Apply Online at www.fafsa.gov and print & attach confirmation page.)
APPLICATION FOR ADMISSION
TO THE
INSTITUTE FOR PUBLIC SAFETY
SCHOOL OF CRIMINAL JUSTICE
Select Type Academy Select Campus Select Type
¨ Law Enforcement ¨ Key West Campus ¨ Part Time/Night Time
¨ Corrections ¨ Upper Keys Campus ¨ Full Time/Day Time
(Available in Key West Only)
¨ Cross-over to Law Enforcement
¨ Cross-over to Corrections
Florida Keys Community College
Institute for Public Safety
Main Campus Upper Keys Campus
5901 College Road 89901 US Highway 1
Key West, FL 33040-4397 Tavernier, FL 33070
Office: (305) 809-3200 Fax: (305) 292-5156 Office: (305) 809-3158 Fax: (305)852-8082
Website: http://www.fkcc.edu/academics/criminal-justice.da
Find us also on:
Applicant Name: __________________________________________________________ Date:___________________
LAST NAME FIRST NAME M.I.
Primary phone number: ( _______) _______________ Email Address: ______________________________________
QUALIFICATIONS
In order to comply with the provisions of Section 943.13, Florida Statutes, the following qualifications are required for the position of law enforcement officer:
· You must be at least 19 years of age,
· You must be a citizen of the United States,
· You must be a high school graduate or equivalent,
· You must not have been convicted of any felony, or misdemeanor involving perjury or false statement, not have received a dishonorable or undesirable discharge from any of the Armed Forces of the United States. Any person who, after July 1, 1981, pleads guilty or nolo contendere to or is found guilty of a felony or of a misdemeanor involving perjury or false statement shall not be eligible for employment or appointment as an officer, notwithstanding suspension of sentence or withholding of adjudication. Notwithstanding this subsection, any person who has pled nolo contendere to a misdemeanor involving a false statement, prior to December 1, 1985, and has had such record sealed or expunged shall not be deemed ineligible for employment or appointment as an officer.
· Agree to be fingerprinted by the training school, selection center or authorized agency,
· Pass a physical examination by a licensed physician,
· Be of good moral character,
· Successful completion of a background investigation,
· Complete basic recruit training,
· Complete Affidavit of Applicant Form (CJSTC-68),
· Comply with continuing training or education requirements,
· Pass a Criminal Justice Standards and Training Commission (CJSTC) approved basic skill examination and assessment instrument, based on a job task analysis, and
· Pass the State Licensure exam.
In addition, Federal Law prohibits any individual who has been convicted of a domestic violence charge (felony or misdemeanor) from carrying a firearm. The law prohibits an individual with such a conviction from becoming a law enforcement officer.
ACADEMY FINANCIAL AID AND REFUND DISCLOSURE FORM
All FKCC Academy recruits must register with Financial Aid, regardless of their method of payment. The FAFSA application may be completed online at www.fafsa.gov
As an applicant for a recruit program at Florida Keys Community College, Institute for Public Safety Academy, you are applying for a program of study made up of several individual courses offered to the cohort of students that begin the program together. Each of those courses must be successfully completed in order to continue in the program and the program in its entirety must be successfully completed in order to be eligible to take the State Officer Certification Exam prior to employment in Florida as law enforcement, corrections, or correctional probation officer.
No students may be added to the program by enrolling after the program begins. Regardless of whether the course was taken or not, there will be NO refunds made after the first five (5) days of the start of an Academy.
If you are a student who receives Title IV student financial aid (Federal Pell Grants, Federal SEOG, Federal Stafford Loans or PLUS Loans) and you withdraw, are dismissed, or your classes are canceled for any reason, your financial aid will be reviewed by the College under the Federal Return to Title IV policy, as required by the Federal Government.
Students who withdraw or are dismissed and who receive Title IV Federal financial aid may owe the Federal Government, TCC, or both, money based on the determination of the Federal review. These funds would be in addition to any tuition you may owe.
If you have any questions about your potential financial liability, you are directed to contact the College’s Financial Aid Office for assistance before enrolling in this program. Your signature below acknowledges you have read and understand your financial obligations as described above.
_________________ __________________________________________________
Date Applicant Signature
INFORMATION RELEASE FORM
NAME OF APPLICANT: _________________________________________________________
DATE OF BIRTH: _________________________________________________________
SOCIAL SECURITY NUMBER: _______________ - _______________ - _______________
ADDRESS: _________________________________________________________
PHONE #: ( _____________ ) _______________ - ________________________
E-MAIL ADDRESS: _________________________________________________________
To Whom It May Concern:
I am an applicant for admission to the Florida Keys Community College, Institute for Public Safety, and Law Enforcement Academy.
In order for the FKCC Institute for Public Safety to conduct a comprehensive investigation prior to my admission, it may be necessary for certain information that might otherwise be confidential, be released to them. Further, I hereby acknowledge that if I am accepted for admission, it may also become necessary for the Institute to conduct an investigation of me during my Academy class.
This release authorizes disclosure of records including, but not limited to, education records, attendance records, achievement records, medical records, employment records, personal history, performance results, background investigations, polygraph examination results, any and all internal affair investigations and disciplinary records, and credit records to representatives of the Institute at any time prior to the scheduled graduation date of my class from the Institute.
By copy of this form, I hereby authorize the release (including duplication of records) to representatives of the Institute for Public Safety and any and all records concerning me you may hold.
I HEREBY, release you, as the custodian of such records, and any school, college, university, or other educational institution, hospital or other repository of medical records, credit bureau, lending institution, consumer reporting agency, or retail business establishment including collectively, from any and all liability for damage of whatever kind, which may at any time result to me, my heirs, family or associates because of compliance with this authorization and request to release information, or any attempt to comply with it. Should there be any questions as to the validity of the release, you may contact me as indicated above.
_________________ __________________________________________________
Date Applicant Signature
SIGNATURE TO BE WITNESSED BY AN FKCC – IPS STAFF MEMBER
_________________ __________________________________________________
Date IPS Staff Signature
FLORIDA KEYS COMMUNITY COLLEGE
INSTITUTE FOR PUBLIC SAFETY
APPLICATION INSTRUCTIONS
DIRECTIONS: Please read these instructions very carefully. The application must be completed exactly according to directions. Your ability to complete the enclosed document as required will be evaluated and used as part of the Academy selection process.
Requirement Check List is provided as a guideline in order of importance. Ensure copies of all applicable documents are attached. If a document is not applicable to your admission application, mark the checklist with N/A (not applicable). (Example: if you have not attended college, write N/A on the blank line in item #4.) College transcripts must be sent directly from your previous college to the Institute for Public Safety – copies will not be recognized as official.
· Application of Admission, Florida Keys Community College. For quick processing, please complete and pay ONLINE at www.fkcc.edu and click on the “APPLY NOW” button on the top right-hand corner. Otherwise, you must submit a complete application along with a non-refundable $30.00 application fee and return to the Key West Admissions Office. Each new applicant is charged this fee. This is a one-time application fee and covers all subsequent enrollments. If you have previously enrolled in any course at Florida Keys Community College, this application fee is not required.
IMPORTANT - Under the degree area - check the box for PSAV major and enter code 620)
· Application to Institute for Public Safety must be completed as stated in the directions. Any omission, falsification, misstatement or misrepresentation of any portion of this application will be the basis for disqualification or dismissal from the Academy. Completion of an Application to the Institute for Public Safety does not guarantee acceptance into the Academy.
· The Physical Fitness Assessment (CJSTC Form 75B) is required for all students attending Basic Recruit Training. This form must be completed by the Applicant and an Examining Physician. Physical Fitness Condition Program is attached.
· Criminal History Background Check is required on all applicants entering a basic recruit-training program. This is done using fingerprinting to conduct a background analysis on applicants. Applicants are required to obtain their fingerprints using our Agency ORI, FL922240Z. Fingerprints may be obtained at the following Monroe County Sheriff’s Offices in Key West, Marathon, or Plantation Key.
Monday-Friday 9am-11am and 1pm-3pm. Call to verify availability.
Stock Island Detention Center 305-293-7348
Marathon Substation 305-289-2430
Roth Building, Plantation Key 305-853-3211
Please return the completed Application to: Florida Keys Community College
Institute for Public Safety
Key West Campus, 5901 College Road, Key West, FL, 33040-4397 or
Upper Keys Campus, 89901 US Highway 1, Tavernier, FL 33070.
DO NOT MAIL TUITION FEES WITH THIS APPLICATION
The Institute for Public Safety may require applicants to attend an Interview Board. Applicants will be notified of their selection to the Basic Law Enforcement Academy by mail.
HOW TO OBTAIN A COPY OF YOUR DRIVING RECORD
OPTION # 1: BY MAIL
To obtain a copy of a driving record , please submit a written request which includes the individual’s full name, date of birth or approximate age, social security number, Florida driver license number (if available) and the address where to send the record, along with the appropriate fee ($10.00 for a 7-year record. Payable by personal check or money order to the Division of Driver Licenses) to:
Bureau of Records
P. O. Box 5775
Tallahassee, FL 32314-5775
If you wish to use a next day delivery carrier, please send your request to:
Bureau of Records
2900 Apalachee Parkway, MS 90
Tallahassee, FL 32399-0575
OPTION # 2: IN PERSON
Visit the Miami-Dade Clerk of Courts, Richard E. Gerstein Building, 1351 NW 12 Street, Room 124, Miami, FL 33125. Monday-Friday, 9:00 A.M. to 4:00 P.M. Cost is $17.00 for a 7-year record plus $1 for each additional page.
OPTION # 3: PRIVATE VENDOR
Visit the following website: http://www.flhsmv.gov/data/internet2.html
INSTITUTE FOR PUBLIC SAFETY
FLORIDA KEYS COMMUNITY COLLEGE
INSTRUCTIONS: Print legibly, using a ballpoint pen. DO NOT TYPE. Please ensure that all questions are answered completely, accurately, and truthfully. If any item does not pertain to you, please answer “N/A” (not applicable). Keep in mind that all information will be checked and verified. Please note that any misstatements, falsifications, or omissions may delay entrance to Institute for Public Safety.
LAST NAME FIRST NAME MIDDLE NAME MAIDEN
STREET ADDRESS (NOT P.O. BOX)
MAILING ADDRESS IF DIFFERENT THAN ABOVE
CITY COUNTY STATE ZIP CODE
_____________________________ SEX: MALE_______ FEMALE_________
HOME TELEPHONE
_____________________________ 9000 ____ ____ ____ ____ ____
CELLULAR PHONE FKCC STUDENT NUMBER
_____________________________ __________________________________
SOCIAL SECURITY NUMBER DRIVER LICENSE NUMBER/STATE
__________________________ ________________________________
DATE OF BIRTH (MM/DD/YYYY) PLACE OF BIRTH
PHOTO MUST BE TAKEN NO MORE THAN SIX MONTHS PRIOR TO SUBMISSION
1.
List any names you may have used. Please include former names, aliases, and/or nicknames.
2. Ethnic Origin (optional) _____ White ______ Asian or Pacific Islander ______ Hispanic
_____ Black, Non Hispanic ______ American Indian/ Alaskan Native ______ Other
3. Citizenship: U.S. Citizen ______ YES ______ NO
Naturalized Certificate No. ______________________ Country of Origin _________________
Date and Location_____________________________________________________________________