FIRSTNAME *
MIDDLE
LASTNAME *
DOB *
 
SSN
DL#
ADDRESS *
   APT#
   
   CITY
   
   STATE
   
   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: