Date of Application:______________ Academy Year:_______ Received by: (staff)______________ Date received:(staff)_____________ N.C. ACADEMY FOR LAW ENFORCEMENT EXPLORERS APPLICATION FOR APPOINTMENT Instructions: Complete all information asked for in this application. N.C.A.L.E.E. Medical Release/Permission form must be complete and submitted with application. BSA Personal Health and Medical Record form - ( optional - submit if required by your post/council). Submit a $15.00 application fee. (This fee will be applied to the total cost of the Academy if accepted to attend, fee will be refunded if not appointed to Academy). Academy fee: $ 100.00 NAME_____________________________________________AGE________SEX: M/F______ ADDRESS_____________________________________________________________________ ______________________________________________________________________ PARENTS NAME______________________________________________________________ ADDRESS_____________________________________________________________________ ___________________________________E-MAIL___________________________ HOME PHONE#____________________BUSINESS PHONE#_________________________ EXPLORER POST/AGENCY________________________________________POST #_____ AGENCY ADDRESS____________________________________________________________ ____________________________________________________________ AGENCY PHONE #:______________________POST ADVISOR_______________________ ADVISOR/AGENCY E-MAIL ____________________________________________________ POST INSURANCE INFORMATION:_____________________________________________ Page 2 Answer the following questions: How long have you been a member of your Post_______________________________________ Have you previously attended the N.C. Academy for Law Enforcement Explorers ?_________ If yes, give year of attendance___________and class: basic or advanced___________________ Current position you hold in your Post, if any_________________________________________ Describe yourself; include your strengths and your weaknesses; interests and hobbies; etc.___ Write a brief explanation why you should be selected to attend the N.C. Academy for Law Enforcement Explorers, and what you hope to gain from the Academy. T-Shirt Size (circle) S M L XL XXL Date of Application:______________ Academy Year:_______ Received by: (staff)______________ Date received:(staff)_____________ N.C. ACADEMY FOR LAW ENFORCEMENT EXPLORERS APPLICATION FOR APPOINTMENT Instructions: Complete all information asked for in this application. N.C.A.L.E.E. Medical Release/Permission form must be complete and submitted with application. BSA Personal Health and Medical Record form - ( optional - submit if required by your post/council). Submit a $15.00 application fee. (This fee will be applied to the total cost of the Academy if accepted to attend, fee will be refunded if not appointed to Academy). Academy fee: $ 100.00 NAME_____________________________________________AGE________SEX: M/F______ ADDRESS_____________________________________________________________________ ______________________________________________________________________ PARENTS NAME______________________________________________________________ ADDRESS_____________________________________________________________________ ___________________________________E-MAIL___________________________ HOME PHONE#____________________BUSINESS PHONE#_________________________ EXPLORER POST/AGENCY________________________________________POST #_____ AGENCY ADDRESS____________________________________________________________ ____________________________________________________________ AGENCY PHONE #:______________________POST ADVISOR_______________________ ADVISOR/AGENCY E-MAIL ____________________________________________________ POST INSURANCE INFORMATION:_____________________________________________ Page 2 Answer the following questions: How long have you been a member of your Post_______________________________________ Have you previously attended the N.C. Academy for Law Enforcement Explorers ?_________ If yes, give year of attendance___________and class: basic or advanced___________________ Current position you hold in your Post, if any_________________________________________ Describe yourself; include your strengths and your weaknesses; interests and hobbies; etc.___ Write a brief explanation why you should be selected to attend the N.C. Academy for Law Enforcement Explorers, and what you hope to gain from the Academy. T-Shirt Size (circle) S M L XL XXL Date of Application:______________ Academy Year:_______ Received by: (staff)______________ Date received:(staff)_____________ N.C. ACADEMY FOR LAW ENFORCEMENT EXPLORERS APPLICATION FOR APPOINTMENT Instructions: Complete all information asked for in this application. N.C.A.L.E.E. Medical Release/Permission form must be complete and submitted with application. BSA Personal Health and Medical Record form - ( optional - submit if required by your post/council). Submit a $15.00 application fee. (This fee will be applied to the total cost of the Academy if accepted to attend, fee will be refunded if not appointed to Academy). Academy fee: $ 100.00 NAME_____________________________________________AGE________SEX: M/F______ ADDRESS_____________________________________________________________________ ______________________________________________________________________ PARENTS NAME______________________________________________________________ ADDRESS_____________________________________________________________________ ___________________________________E-MAIL___________________________ HOME PHONE#____________________BUSINESS PHONE#_________________________ EXPLORER POST/AGENCY________________________________________POST #_____ AGENCY ADDRESS____________________________________________________________ ____________________________________________________________ AGENCY PHONE #:______________________POST ADVISOR_______________________ ADVISOR/AGENCY E-MAIL ____________________________________________________ POST INSURANCE INFORMATION:_____________________________________________ Page 2 Answer the following questions: How long have you been a member of your Post_______________________________________ Have you previously attended the N.C. Academy for Law Enforcement Explorers ?_________ If yes, give year of attendance___________and class: basic or advanced___________________ Current position you hold in your Post, if any_________________________________________ Describe yourself; include your strengths and your weaknesses; interests and hobbies; etc.___ Write a brief explanation why you should be selected to attend the N.C. Academy for Law Enforcement Explorers, and what you hope to gain from the Academy. T-Shirt Size (circle) S M L XL XXL Date of Application:______________ Academy Year:_______ Received by: (staff)______________ Date received:(staff)_____________ N.C. ACADEMY FOR LAW ENFORCEMENT EXPLORERS APPLICATION FOR APPOINTMENT Instructions: Complete all information asked for in this application. N.C.A.L.E.E. Medical Release/Permission form must be complete and submitted with application. BSA Personal Health and Medical Record form - ( optional - submit if required by your post/council). Submit a $15.00 application fee. (This fee will be applied to the total cost of the Academy if accepted to attend, fee will be refunded if not appointed to Academy). Academy fee: $ 100.00 NAME_____________________________________________AGE________SEX: M/F______ ADDRESS_____________________________________________________________________ ______________________________________________________________________ PARENTS NAME______________________________________________________________ ADDRESS_____________________________________________________________________ ___________________________________E-MAIL___________________________ HOME PHONE#____________________BUSINESS PHONE#_________________________ EXPLORER POST/AGENCY________________________________________POST #_____ AGENCY ADDRESS____________________________________________________________ ____________________________________________________________ AGENCY PHONE #:______________________POST ADVISOR_______________________ ADVISOR/AGENCY E-MAIL ____________________________________________________ POST INSURANCE INFORMATION:_____________________________________________ Page 2 Answer the following questions: How long have you been a member of your Post_______________________________________ Have you previously attended the N.C. Academy for Law Enforcement Explorers ?_________ If yes, give year of attendance___________and class: basic or advanced___________________ Current position you hold in your Post, if any_________________________________________ Describe yourself; include your strengths and your weaknesses; interests and hobbies; etc.___ Write a brief explanation why you should be selected to attend the N.C. Academy for Law Enforcement Explorers, and what you hope to gain from the Academy. T-Shirt Size (circle) S M L XL XXL |