FIRSTNAME
*
MIDDLE
LASTNAME
*
DOB
*
SSN
DL#
ADDRESS
*
APT#
CITY
STATE
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
D.C.
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP
*
PHONE
*
E-MAIL
*
PHYSICAL DESCRIPTION
HEIGHT
WEIGHT
HAIR COLOR
EYE COLOR
GLASSES
SCARS/MARKS
DISABILITIES
VEHICLE INFORMATION
OWNER NAME
TAG#
YEAR
MAKE/MODEL
INSURANCE CARRIER
SCHOOL INFORMATION
NAME
GRADE
GPA
PRINCIPAL
COUNSELOR
PHONE
EMPLOYMENT INFORMATION
BUSINESS
SUPERVISOR
PHONE
HOUR WORKED PER WEEK
POSITION
DUTIES
CONTACT INFORMATION
** PLEASE COMPLETE ADDRESS & PHONE INFORMATION IF A PARENTS ADDRESS IS DIFFERENT FROM YOURS
FATHER
MOTHER
ADDRESS
CITY/STATE
PHONE
PLEASE WRITE A SHORT NARRATIVE WHY YOU WANT TO BE A MEMBER OF
THE SHELBY COUNTY SHERIFF'S OFFICE EXPLORER POST:
S
ubmit
Upon submittal of this form, you will receive a confirmation email, and you will be contacted regarding your application and the current schedule.