corrections officer orientation packet - miami dade corrections orientation packet... ·...

MDC School of Justice/ Revised April 2016

SCHOOL OF JUSTICE BASIC CORRECTIONS TRAINING PROGRAM

Corrections Officer

Orientation Packet

All applicants to corrections training programs must attend an orientation session

conducted on Tuesdays at 6 p.m. in Bldg. 8, Room 8116.

I, _______________________________________ attended an

orientation session _____________________ 2016.

School of Justice verification stamp



“The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, to

have it make some difference that you have lived and lived well.”

- Ralph Waldo Emerson

Those who consider a career in public service are special people. More so, are those who dedicate

their lives to preserving the safety of communities and helping others who are less fortunate and often

times incapable of helping themselves. That you are reading this passage in preparation of entry into

basic law enforcement or corrections training program suggests you are a special person too.

On behalf of the more than 300,000 law enforcement professionals nationwide and the 6,600 police

and correctional officers in Miami Dade County alone we encourage you to forge forward. Contained

within this packet is information on how to apply for acceptance into a basic training program,

estimated expenses associated with attending an academy class and the various required tests you

must complete in order to be considered.

The Miami Dade College School of Justice has earned the reputation as a premier provider of training

and education for criminal justice practitioners in the Southeastern United States. On average more

than 300 students graduate annually from our basic police and corrections training programs and an

equal number from our career development courses. Our staff, eminently qualified is seasoned and

talented with the unique ability to turn training concepts into performance outcomes.

Today symbolizes the start of your journey; from applicant to recruit to correctional professional and

we assure you of our commitment to your success.

Sincerely,

Dr. Raimundo J Socorro, Director

Miami Dade College School of Justice

http://thinkexist.com/quotation/the_purpose_of_life_is_not_to_be_happy-it_is_to/223943.html

http://thinkexist.com/quotation/the_purpose_of_life_is_not_to_be_happy-it_is_to/223943.html



INDEX

1. Orientation Information Page 4

2. General Information and Minimum Requirements Page 5

3. Application Process Page 6

4. Payment Schedule & Financial Assistance Page 7

5. Required Documentation for Application Page 8

6. FBAT Candidate Testing Information Page 9

7. FBAT Definitions Page 10 & 11

8. Physical Examination Process Page 12

9. Instructions for Completing Form CJSTC-75 Page 13

10. Physician’s Assessment CJSTC 75 Page 14

11. Instruction for Completing Form CJSTC-75A Page 15

12. Patient Information CJSTC-75A Page 16

13. Instruction for Completing Form CJSTC-75B Page 17

14. Physician Fitness Assessment CJSTC 75B Page 18



ORIENTATION FOR CORRECTIONS

TRAINING PROGRAM IS CONDUCTED ON

TUESDAY NIGHTS IN BUILDING 8000,

ROOM 8116.

TIME: 6 p.m. – 8 p.m.

INTERESTED STUDENTS MUST RESERVE

A SEAT BY CALLING 305-237-1400

NO LATER THAN 12:00 P.M ON TUESDAY

For admission

Arrive on time

Dress in business attire

Have a pen and pad

Have photo identification



GENERAL INFORMATION

The Full-Time Basic Corrections Academy runs for approximately 4 ½ months, Monday - Friday,

7:30 A.M. to 5:00 P.M. Class hours do change during the training to achieve certain objectives. On

graduation and passing of the State Officer Certification Examination you are considered a certified

correctional Officer.

Times, dates, schedules and fees are subject to change at the discretion of Miami Dade College.

MINIMUM REQUIREMENTS

Applicants for a basic corrections training program must;

Submit a completed Personal History Questionnaire

Be at least 19 years of age and a United States citizen

Have a high school diploma or equivalent

Be of good moral character as defined by 11B-27.0011 of the Florida Administrative Code.

Have not been convicted of any felony including a “withholding of adjudication” nor convicted

of a misdemeanor involving perjury or false statement. Any and all arrests will be reviewed by

the School of Justice

Have a valid Florida Driver’s License and no more than 4 moving violations within the past 36

months; No Driver’s License suspensions within the past 5 years; No conviction of D.U.I.

including a “No Contest Plea” within the past 10 years; and No convictions for reckless driving,

fleeing, or leaving the scene of an accident.

Submit to a physical examination, including screening for illegal substances by a licensed

physician.

Submit to a criminal history verificatio

For information on the Basic Corrections program

Contact Barbara Goodman

Phone #: 305-237-8441, Room #8201-7, Monday - Friday, 9 a.m. - 2 p.m.

Email: [email protected]



APPLICATION PROCESS

The application process is designed to identify individuals best suited for a career in corrections.

Miami Dade College as an institution of higher learning and vocational training is guided in the

administration of its programs by the Southern Association of Colleges and Schools and Florida

Department of Education. The School of Justice must adhere to these standards as well as those of

the Florida Department of Law Enforcement, Criminal Justice Standards and Training Commission.

Prior to submitting the required information and documents, each applicant must take the following

tests, and must be completed 15 to 20 days prior the first day of class:

1. Attending an orientation session.

2. Completion of the Application Package

3. Passing score Florida Basic Abilities Test

4. Physical Examination

5. Background/ Criminal History

6. Administrative Interview

7. Final review by School of Justice Administration

Applicants are scheduled for Training at the discretion of School of Justice staff.



SUBTOTAL-1 $120.00

SUBTOTAL-2 $3,390.80 - $3,520.80

ESTIMATED TOTAL

$3,510.80 - $3,640.80

PAYMENT SCHEDULE & FINANCIAL ASSISTANCE

Applicants are responsible for paying all fees relative to the application process. Financial Aid,

Student Loans, G.I. Bill, and Pre-paid College Programs pay tuition costs only.

The following represents costs associated with the application process and basic training program:

Fees are subject to change without notice

F-BAT Test: $ 45.00

Background/Criminal History: $ 60.00

Physical Exam: $225.00*

** Academy Costs: these are estimated costs

Tuition: $ 2,920.80

Uniforms: $ 300.00

State Exam: $ 100.00

Health Insurance: $ 70.00 - $200.00 (Depends on age)

*Prices may vary depending on Physician.

** If you are planning to apply for financial aid or a student loan, it is your responsibility to have

this completed by the date your class begins. Financial aid can only be used to offset tuition costs

and all other costs are the responsibility of the applicant and must be paid as necessary.

*** For more information about financial aid or student loans, contact this phone #: (305) 237-1058

or visit their website: www. mdc.edu/financial –aid/.

**** The course code for basic corrections training is 50720.

Legible copies of the following documents are required with your completed Personal History

Questionnaire (PHQ). Presenting falsified or fraudulent documents will result in denial of admission

to the School of Justice and possible criminal prosecution.



DOCUMENTATION FOR APPLICATION

Legible copies of the following documents are required with your completed Personal History

Questionnaire (PHQ). Presenting falsified or fraudulent documents will result in denial of admission

to the School of Justice and possible criminal prosecution.

Required Documents

1. Receipt of paid application fee.

2. PHQ w/valid BLE orientation stamp (available via the School of Justice website:

http://www.mdc.edu/main/justice/training/law_enforcement.aspx)

3. Copy of High School Transcript

4. Copy of Birth Certificate.

5. Proof of Citizenship (US Naturalization Certificate or Passport)

6. Copy of Social Security Card

7. Copy of Valid State of Florida Driver’s License

8. Valid DD-214 (Long Form) for honorable military discharge (if applicable)

9. Official Driving record for the past 7 years, and/or any out of state driving records if not a

full-time Florida resident for the past 7 continuous years. Copies can be obtained in Miami-

Dade Courthouse at 1351 NW 12 St., Miami, FL 33125 or in Broward County Courthouse

at 201 SE 6TH Street, Ft. Lauderdale, FL 33301. If applicant is not a Florida resident for the

past 7 years driving record is required from previous state. ***Note the driving record must

contain the courthouse seal. ***

10. Credit History and Score for the past twelve (12) months – for a credit history report, visit

www.annualcreditreport.com or call 1-877-322-8228. If applicant has not established

credit/score report is still required.

11. F-BAT or CJ-BAT (Law Enforcement) results

12. Proof of current and valid health/ medical insurance coverage.

13. FDLE Physical Exam Forms (CJSTC-75, 75A, 75B and 75C)

14. Physical Examination including 7- Panel Drug Test Results (Refer to pg. 12)

Optional Documents

1. College transcripts and/or Degrees

2. Letters of recommendation

**Foreign documents (e.g. Birth Certificate, Transcripts, Diplomas) require certified translation.**

http://www.mdc.edu/main/justice/training/law_enforcement.aspx

http://www.annualcreditreport.com/



The Florida Basic Abilities Test (FBAT) is a suite of exams designed to assess the following eight

(8) abilities.

Deductive Reasoning

Inductive Reasoning

Information Ordering

Memorization

Problem Sensitivity

Spatial Orientation

Written Comprehension

Written Expression

The Florida Department of Law Enforcement (FDLE) has identified these abilities as essential for

successful academy performance.

The exams are discipline specific. The LEBAT is for Law Enforcement and the COBAT is for

Corrections.

1. F-BAT testing is conducted on a walk-in basis on Mondays, Wednesdays, and Thursdays at

9:00 a.m. and 1:00 p.m. in Building 9, room 9108. Space is limited and seats are provided on

a first come, first served basis. You will not be admitted into the testing room once the test

has begun. To be admitted to the testing room, you must bring a valid government-issued

photo ID and a paid receipt.

2. The cost of the F-BAT test is $45.00 payable in cash or money order only. Payment must be

made at the Miami Dade College, North Campus, Bursar’s Office, Building 1, Room; 1154,

prior to taking the F-BAT test. Receipts are valid for 30 days and are non-refundable and

non-transferable.

3. Passing FBAT scores are valid for four (4) years from the test date. A passing score is 77%

for Corrections and 71% for Law Enforcement.

4. If you fail the FBAT, you may retake the exam up to three times within a 12-month period.

You may make three attempts per discipline within a 12-month period. There is a 24-hour

waiting period between retakes.

5. Study guides are available through the FBAT office, located at Miami Dade College, North

Campus; Room #8324. Office hours are Monday – Friday, 8:30 a.m. to 5:00 p.m. Please call

305-237-1722 to ensure study guide availability.



FBAT Abilities Briefing

1. Deductive Reasoning

This is the ability to apply rules to specific problems to come up with logical answers. This ability

involves applying general rules to specific problems.

You would use this ability when applying Florida Statues or Florida Manual on Jail Standards,

policies and procedures to specific situations. Example; under what conditions to make an arrest or

the proper use of force, in deciding which route to take when taking into account time and geography.

2. Inductive Reasoning

The ability to combine separate pieces of information, or specific answers to problems to form general

rules or conclusion. It involves the ability to think of possible reason why things go together, such as

giving a logical explanation for a series of events that seem unrelated.

You would use this ability when performing any type of investigation to conclude that rules or

laws have been violated.

3. Information Ordering: The ability to correctly follow a rule or set of rules in order to arrange things or actions in a certain

order. The rules must be given. The things or actions must be put in order and can include numbers,

letters, words, pictures, procedures, sentences and logical operations.

You would use this ability when making an arrest/issuing a warrant or transporting prisoners,

conducting fire drills. It is also used in applying first aid, following a checkout procedure in operating

equipment, arranging sentences in a meaningful paragraph.

4. Memorization: This is the ability to remember information such as works, numbers, pictures and procedures.

You would use this ability to remember the important information presented in the Florida

Statues, legal bulletins, and shift briefings, BOLOs remembering new names, faces, codes, telephone

numbers, geographic locations, documents and long lists.

5. Problem Sensitivity: This is the ability to tell if something is wrong or likely to go wrong.

You would use this ability when patrolling or interacting with individuals where you have to judge

whether or not a situation is going to deteriorate or get worse. It could involve recognizing the

symptoms of a physical problem requiring first aid, the likelihood that a riot or other type of

disturbance may occur. It could also involve judging the accuracy of data received.



6. Spatial Orientation: Ability to tell where you are in relation to the location of some objects, or to tell where the object is

in relation to you. It involves maintaining directional orientation in one’s bearings with respect to the

points of a compass. The ability allows one to stay oriented in a vehicle as it changes direction and

location.

You would use this ability when out in the community patrolling and a call comes in that you must

attend to. You must visualize where you are in relation to where you are going to be able to get there.

7. Written Comprehension: Involves reading and understanding written words and sentences.

You would use this ability when reading legal bulletins, Florida statutes, ordinances, policies and

procedures.

8. Written Expression: Involves writing words and sentences so others will understand.

You would use this ability when it is necessary to write incident/ use of force/ discipline

reports, memos, affidavits or narratives.

For more information and sample test questions, visit the FBAT website:

www.mdc.edu/north/f-ba


PHYSICAL EXAMINATION PROCESS

The physical examination can be completed by a Doctor of your choice, which must include a 7

panel narcotics screen in compliance with 11B-27.00225.

11B-27.00225 shall include the analysis of a urine sample furnished by the applicant for the

presence of controlled substances or metabolites, which shall be consistent with the procedures for

drug testing pursuant to Section 112.0455m, F.S. and Rule Chapter 59A-24, F.A.C., which have

been adopted by the Agency for Health Care Administration.

a) The procedures for collection sites and specimen collection comply with the requirements of

Rule 59A-24.005, F.A.C.

b) Each applicant gave written consent prior to giving the sample for collection, analysis for

evidence of controlled substances, and disclosure of the analysis results to the employing

agency and to the Commission.

c) The procedures for analyzing and reporting the urine sample were consistent with Rule 59A-

24.006, F.A.C.

d) Seven Substances:

1. Amphetamines (amphetamine and methamphetamine)

2. Cannabis or Cannabinoids

3. Cocaine or Cocaine Metabolite

4. Phencyclidine

5. Opiates (codeine and morphine)

6. Barbiturates

7. Benzodiazepines

You are responsible for payment as well as returning forms to the School of Justice Recruitment

office prior to start of your academy session.

CJSTC-75

CJSTC-75 page 2

CJSTC-75A

CJSTC-75A page 2

Florida Department of Law Enforcement

PHYSICAL FITNESS ASSESSMENT

Incorporated by Reference in Rule 11B-35.001(10)(d)14., F.A.C.

Created 11/8/2007 Training School: Original Agency: Copy 1 of 2 Applicant: Copy Commission-Approved: 11/6/2014 Form Effective Date: 7/2015

CJSTC

75B

1. Applicant’s Name: Last First MI

2. Applicant’s Address:

3. Enter Last Four Digits of Social Security Number:

4. Training School:

5. The Applicant Is Requesting Admission Into a Basic Recruit Training Program for One of the Following Disciplines:

Law Enforcement Correctional Correctional Probation

6. Student Participation in Basic Recruit Training Program Activities. A student enrolled in a basic recruit training program (BRTP) is required to participate in the following activities:

A. Defensive tactics and firearms high-liability training is a component of the curriculum mandated by the Criminal Justice Standards and Training Commission. Firearms training requires firing a handgun and long gun creating exposure to lead. Defensive tactics training requires sustained physical exertion and chemical agent contamination to the chemicals oleo-resin capsicum (OC) and/or orthochlorobenzal-malonotrite (CS).

B. Physical Fitness Conditioning and Physical Fitness Testing: A BRTP student shall participate in physical fitness conditioning and a fitness test and includes thefollowing measures:

Vertical Jump One Minute Sit Ups 300 Meter Run Maximum Push Ups 1.5 Mile Run/Walk

C. The training center director has attached the training schools physical fitness conditioning program: Yes

**********TO BE COMPLETED BY THE APPLICANT*********

7. Medical Conditions Regarding OC/CS Contamination. A BRTP student should be aware of the following personal considerations that may restrict participation in the chemical agent contamination of the BRTP and could possibly be aggravated to a severe degree during the contamination: Recent eye surgery, heart problems, panic disorder or stress, respiratory disorder, emphysema (loss of elasticity/thinning of lung tissues), bronchial asthma, x-ray evidence of pneumoconiosis (black lung), evidence of reduced pulmonary (lung) function, chronic obstructive pulmonary disease, coronary (heart) artery disease, cerebral (brain) blood vessel disease, severe or progressive hypertension (high blood pressure), epilepsy, grand mal or petite mal (seizures), pernicious anemia (severe reduction in red blood cells), diabetes (any form), pueumomediastinum gap (air in the sac surrounding lungs), history of skin allergies, or any condition for which the student is presently taking medication.

8. BRTP Student Certification. I certify that I have reviewed the above information and I do or do not have any medical restrictions that would prevent me from

participating in the basic recruit training program activities outlined in item numbers 6, 6A, and 6B above.

9. Student’s Printed Name:

10. Student’s Signature: Date:

11. Prior Exposure to OC or CS. For a student who has had prior chemical agent exposure that includes chemical agent contamination and working through the effects of chemical agent contamination in a training environment, please attach the supporting documentation of prior exposure and check one of the following boxes:

I certify that I have OR I have not been exposed to oleo-resin capsicum (OC) and/or orthochlorobenzal-malononitrile (CS) in the manner described in item

number 11 above.

**********TO BE COMPLETED BY THE EXAMINING PHYSICIAN*********

12. Physician Attestment. The above applicant is seeking entry into a law enforcement, correctional, or correctional probation basic recruit training program. Rule 11B-35.001(14)(b), F.A.C., requires a complete physical examination at a level of specificity sufficient to determine whether there are any medical or physiological restrictions that would prevent the applicant from performing the required activities described in items 6, 6A, and 6B above. Disabilities, impairment, or limitations identified by the examination that would prevent the applicant from performing the required activities should be reported to the training school indicated in item number 4 above.

I hereby attest that I have examined the above named applicant and find him or her CAPABLE of participating in the basic recruit training program activities indicated in item

numbers 6, 6A, and 6B above.

I hereby attest that I have examined the above named applicant and find him or her NOT CAPABLE of participating in the basic recruit training program activities indicated in

item numbers 6, 6A, and 6B above.

13. Physician, Certified Advanced Registered Printed Name Examination Date Nurse Practitioner, or Physician Assistant’s Signature

14. Physician, Certified Advanced Registered Nurse Practitioner, or Physician Assistant’s License Number Licensing State

15. Physician, Certified Advanced Registered Nurse Practitioner, or Physician Assistant’s Professional Address

**********TO BE COMPLETED BY THE TRAINING CENTER DIRECTOR OR DESIGNEE*********

16. Training Center Director or Designee’s Printed Name:

Training Center Director or Designee’s Signature: Date:

FORM CJSTC-75B Page 2 of 2

INSTRUCTIONS FOR COMPLETING FORM CJSTC-75B

A basic recruit student approved to enter a basic recruit training program (BRTP) shall review and complete form CJSTC-75B to indicate the presence of any medical conditions that may prevent participation in the Physical Fitness Program and Chemical Agent Contamination of the BRTP. A copy of the Physical Fitness Program for law enforcement, correctional, or correctional probation discipline shall be attached to this form for the student to review.

1. Applicant’s Name. Enter the applicant’s last name, first name, and middle initial.

2. Applicant’s Address. Enter the applicant’s current address, city, state, and zip code.

3. Applicant’s Social Security Number. Enter the last four digits of the applicant’s social security number as in this example: 000-00-1234.

4. Training School Name. Enter the name of the Commission-certified criminal justice training school where the applicant is enrolled.

5. Basic Recruit Training Program Discipline. Place a check mark in one of the box(es) for the law enforcement, correctional, or correctional probation discipline for which the applicant is requesting admission.

6. Student Participation in Basic Recruit Training Program Activities. Defensive Tactics (includes chemical agent contamination), Firearms, and Physical Fitness Conditioning and Physical Fitness Testing: High-liability training in defensive tactics, firearms, and chemical agent contamination is a component of the curriculum mandated by the Criminal Justice Standards and Training Commission and participation in the activities is a requirement for successfully completing a BRTP. There is no pass or fail at this time. The test results for each of the five required tests will be recorded on the Academy Physical Fitness Standards Report, form CJSTC-67A as “I” if the student did not perform the test component or “D” if the student was dismissed from the basic recruit training program.

A. Defensive Tactics and Firearms Training. Firearms training requires firing a handgun and long gun creating exposure to lead. Defensive tactics training requires sustained physical exertion and chemical agent contamination to the chemicals oleo-resin capsicum (OC) and/or orthochlorobenzal-malonotrite (CS).

B. Physical Fitness Conditioning and Physical Fitness Testing. The Physical Fitness Test includes the following measures and are defined as follows:

Vertical Jump. This measures leg power by measuring how high a person jumps.

One Minute Sit Ups. This measures abdominal, or trunk, muscular endurance. While lying on his or her back, the student will be given one minute to do as many bent-leg sit ups as possible.

300 Meter Run. This measures anaerobic power, or the ability to make an intense burst of effort for a short time period or distance. This component consists of sprinting 300 meters as fast as possible.

Maximum Push Ups. This measures the muscular endurance of the upper body. This component consists of doing as many push ups as possible until muscular failure. Males are required to perform the standard push-up and females have the option to perform the standard or modified push-up.

1.5 Mile Run/Walk. This measures aerobic power or cardiovascular endurance (stamina over time). To complete this component, the student runs or walks a distance of 1.5 miles as fast as possible.

C. A physical fitness conditioning program developed by the training school shall be attached to form CJSTC-75B prior to the student’s examination by a physician, certified advanced registered nurse practitioner, or the physician’s assistant.

7. Medical Conditions Regarding Chemical Agent Contamination. The student shall review the listed medical conditions and list other conditions that may restrict him or her from participating in Chemical Agent Contamination to the chemicals oleo-resin capsicum (OC) and/or orthochlorobenzal-malonotrite (CS).

8. Basic Recruit Training Program Activities Certification. The student shall check the appropriate box to indicate if he or she does or does not have a medical condition that would restrict participation in the BRTP activities indicated in item numbers 6, 6A, and 6B of this form.

9. Student’s Printed Name. The student shall print his or her first name, last name, and middle initial.

10. Student’s Signature and Date. The student shall provide a signature and date to verify the information provided by the student is true and correct.

11. Prior Exposure to Chemical Agent Contamination. The student shall Indicate in the appropriate box if he or she has been previously exposed to chemical agent contamination to the chemicals oleo-resin capsicum (OC) and/or orthochlorobenzal-malonotrite (CS), and shall attach supporting documentation of such contamination.

12. Physician, Certified Advanced Registered Nurse Practitioner, or Physician Assistant’s Attestment. The physician shall check the appropriate box to indicate if the student is capable or not capable of participating in the BRTP activities indicated in item numbers 6, 6A, and 6B of this form.

13. Physician, Certified Advanced Registered Nurse Practitioner, or Physician Assistant’s Signature, Printed Name, and Examination Date. The physician shall complete this item to verify his or her attestment to item number 12 of this form.

14. Physician, Certified Advanced Registered Nurse Practitioner, or Physician Assistant’s License Number and Licensing State. The physician shall complete this item toverify his or her valid license number and licensing state.

15. Physician, Certified Advanced Registered Nurse Practitioner, or Physician Assistant’s Professional Address. The physician shall print his or her complete professional address.

16. Training Center Director or Designee’s Printed Name, Signature and Date. The training center director or designee who signs this form shall print his or her legal first and last name. The training center director or designee shall sign and date this form.

MDC School of Justice/ 4/15/2016 Page 1

Applicant must complete this questionnaire

accurately, truthfully and legibly to ensure

consideration. Incomplete applications will cause a

delay in processing.

It is the applicants responsibility to provide copies of

documentation where noted. The School of Justice is

unable to make copies.

SCHOOL OF JUSTICE

BASIC CORRECTIONS ACADEMY

TRAINING PROGRAM

PHOTO

Applicant Name: ____________________________________

Submission Date: ____________________________________


1. _______________________________________________________________________________ LAST NAME FIRST NAME MIDDLE NAME

2. _______________________________________________________________________________ STREET ADDRESS APARTMENT NO.

_______________________________________________________________________________ CITY COUNTY STATE ZIP CODE

3. _______________________________________________________________________________ RESIDENCE TELEPHONE (AREA CODE) CELL PHONE (AREA CODE)

4. ___________________________________ 5. _______________________________ SOCIAL SECURITY NUMBER DRIVER’S LICENSE NUMBER STATE

6. ___________________________________ 7. MALE FEMALE

DATE OF BIRTH (Month-Day-Year)

8. PLACE OF BIRTH: (INCLUDE PHOTOSTATIC COPY OF BIRTH CERTIFICATE)

_______________________________________________________________________________ CITY COUNTY STATE

9.

(Include a copy of Naturalization Certificate)

10. Race/ Ethnicity: Check appropriate box. (Optional)

White (Non-Hispanic) White (Hispanic) Asian or Pacific Islander Haitian

Black (Non-Hispanic) Black (Hispanic) Native American Indian Other ______

11. Alias(es), Nickname, Maiden Name, or other changes in name.

_______________________________________________________________________________

12. EMERGENCY CONTACT

Name ________________________________________ Relationship _______________________

Address _______________________________________________________________________________

_______________________________________________________________________________

Phone: (Home) ________________________________ (Work) ___________________________

13. Marital Status: SINGLE MARRIED ENGAGED SEPARATED DIVORCED (Optional)

U.S. CITIZEN:

YES

NO

NATIVE

YES

NO

Naturalized

Certificate No.

If derived, Parent

Certificate No.

Date, Place and Court


14. EDUCATION: a. List all high schools attended: (INCLUDE COPIES OF HIGH SCHOOL OR GED DIPLOMA)

NAME LOCATION DATES ATTENDED

From To Years

Completed

GRADUATION

Yes No

b. GED (if applicable)

c. Higher education. List information below for all colleges or universities attended

NAME AND LOCATION OF

COLLEGE OR UNIVERSITY

DATES ATTENDED CREDIT HOURS DEGREE

RECEIVED

YEAR

RECEIVED FROM TO SEMESTER QUARTER

d. Other schools or training (trade, vocational, business or military). Give for each, the name and location of school,

dates after subjects studied, certificate, and any other pertinent data.

DATES NAME OF SCHOOL AND LOCATION COURSES STUDIED

CERTIFIED

FROM TO YES NO

e. Were you ever expelled or suspended from ANY SCHOOL or were you ever disciplined by any school official?

Yes No if yes, give particulars below: ___________________________________________ _______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

15. SPECIAL QUALIFICATIONS AND SKILLS: Indicate type of special license such as pilot, radio operator, etc., showing licensing authority, where the license was first

issued, at date current license expires. (Except vehicle operator’s license). _______________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

16. MILITARY

a. Have you ever served in the United States military or Coast Guard, including R.O.T.C.? Yes No if yes, INCLUDE A PHOTO STATIC COPY OF DD-214)

b. Branch of Service ________________________________ Unit or Ship ____________________________

c. What is your service number? ________________________________________________________________

d. Highest rank held: _________________________________________________________________________

e. What is the type of your discharge? Be exact:


Honorable Dishonorable General Honorable Conditions Other: _____

17. EMPLOYMENT: a. List all jobs you have held in the last TEN years, Place your present or most recent job FIRST. If you need more space,

you may include additional sheets. Include military service in proper time sequence and also all periods of

unemployment. List all self-employment, part-time, temporary, seasonal and voluntary jobs.

FROM

NAME OF EMPLOYER

PART-TIME FULL TIME

JOB TITLE

TO DATE

STREET ADDRESS

PHONE NO. (Area Code)

DESCRIPTION OF DUTIES

SALARY BEGIN

CITY, STATE, ZIP CODE

NAME OF SUPERVISOR

SALARY END

WHY DID YOU LEAVE?

FROM

NAME OF EMPLOYER

PART-TIME FULL TIME

JOB TITLE

TO DATE

STREET ADDRESS



SALARY BEGIN


NAME OF SUPERVISOR

SALARY END

WHY DID YOU LEAVE?

NAME OF CO-WORKER

FROM

NAME OF EMPLOYER

PART-TIME FULL TIME

JOB TITLE

TO DATE

STREET ADDRESS



SALARY BEGIN


NAME OF SUPERVISOR

SALARY END

WHY DID YOU LEAVE?

NAME OF CO-WORKER

FROM

NAME OF EMPLOYER

PART-TIME FULL TIME

JOB TITLE

TO DATE

STREET ADDRESS



SALARY BEGIN


NAME OF SUPERVISOR

SALARY END

WHY DID YOU LEAVE?

NAME OF CO-WORKER

FROM

NAME OF EMPLOYER

PART-TIME FULL TIME

JOB TITLE


TO DATE

STREET ADDRESS



18. VEHICLE OPERATOR’S LICENSE: (Driver’s, Chauffeur’s etc. ATTACH PHOTO STATIC COPY OF DRIVER’S LICENSE)

a. Can you operate a motor vehicle? Yes No

Do you now or did you ever possess a valid driver’s license from the State of Florida?

Yes No Driver’s License #____________________________________

Date issued ____________________________ Restrictions ________________________________________

b. Did you ever possess a driver’s license issued by any state other than Florida?

Yes No If yes, provide the following information _________________________________________

Driver’s License #_______________________________________ State ____________ Date issued ______

Restrictions ______________________________________________________________________________

________________________________________________________________________________________

19. CHARACTER REFERENCES:

(Do not include relatives, former employers, supervisors or persons living outside the United State of Territories). List

only character references who have definite knowledge of your qualifications for the position for which you are apply.

List 4 character references.

NAME OF CHARACTER

REFERENCE YEARS

KNOWN ADDRESS

(Street, City, State, Zip Code)

PHONE NUMBER

Business Residence

20. PAST AND/ OR PRESENT MEMBERSHIP IN ORGANIZATION:

NAME, ADDRESS AND PHONE NO. TYPE

(Social, Fraternal, Unions,

Professional, Academic, Etc.…)

OFFICE OR

POSITION HELD

MEMBERSHIP

From To

21. Are there any incidents in your life not mentioned herein which may reflect upon your suitability to enter

a criminal justice training program which require further explanation?

Yes No If yes, State reasons why?

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________


________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

_________________________________________

Applicant Name

_____________________ ____________________ ________________________________

Applicant Signature Date

22. The following is to be executed PRIOR to submission:

I hereby swear or affirm that there are no misrepresentations or omissions in or falsifications of the above

statements and answer to the questions. I am aware that should investigation disclose such misrepresentations,

falsifications or omissions, my application will be rejected and I will be disqualified from present processing for selection

to the Corrections Academy at the School of Justice or if during my acceptance for training, subsequent investigation

should disclose misrepresentation, falsifications or omissions, it will be cause for immediate dismissal from the training

academy.

Date ______________________ ______________________________________________________________ Signature of Applicant

Subscribed and sworn to before me this _______________________________ day of _______________, 20______

By ____________________________________________________________________________________________ (Name of Affiant)

State of ____________________________ ___________________________________________

Signature of Notary Public

County of __________________________ ___________________________________________

Notary Public, Print Name

NOTARY PUBLIC SEAL OF OFFICE:

Personally Known to me or Produced Identification

Type of identification produced _______________________

My commission expires: _________________________________________________

_______________________________________ DID take an oath or DID NOT take an oath


AUTHORIZATION TO OBTAIN AND RELEASE INFORMATION

I hereby authorize the Director of the School of Justice or his staff to solicit information from any person or organization

relative to my qualification for enrollment in the Corrections Academy.

I also authorize the Director of the School of Justice or their staff to release to any criminal justice agency investigating

me as an applicant, all information and testing regarding my academic, professional, and social history while enrolled at

this school.

_______________________________________________ _____________________________

Signature Date

_______________________________________________

Print Your Name

Submit completed application to:

Applicant Processing Miami Dade College, North Campus School of Justice 11380 NW 27th Avenue

Miami, Florida 33167-3495

(305) 237-1400

23. The following is to be executed PRIOR to submission:

I hereby swear or affirm that there are no misrepresentations or omissions in or falsifications of the above

statements and answer to the questions. I am aware that should investigation disclose such misrepresentations,

falsifications or omissions, my application will be rejected and I will be disqualified from present processing for selection

to the Basic Recruit Academy at the School of Justice or if during my acceptance for training, subsequent investigation

should disclose misrepresentation, falsifications or omissions, it will be cause for immediate dismissal from the training

academy.

Date ______________________ ______________________________________________________________ Signature of Applicant

Subscribed and sworn to before me this _______________________________ day of _______________, 20______

By ____________________________________________________________________________________________ (Name of Affiant)

State of ____________________________ ___________________________________________

Signature of Notary Public

County of __________________________ ___________________________________________

Notary Public, Print Name

NOTARY PUBLIC SEAL OF OFFICE:

Personally known to me or Produced Identification

Type of identification produced _______________________


My commission expires: _________________________________________________

_______________________________________ DID take an oath or DID NOT take an oath

AUTHORIZATION TO OBTAIN AND RELEASE INFORMATION

I hereby authorize the Director of the School of Justice or his staff to solicit information from any person or organization

relative to my qualification for enrollment in the Corrections Academy.

I also authorize the Director of the School of Justice or their staff to release to any criminal justice agency investigating

me as an applicant, all information and testing regarding my academic, professional, and social history while enrolled at

this school.

_______________________________________________ _____________________________

Signature Date

_______________________________________________

Print Your Name

Submit completed application to:

Applicant Processing Miami Dade College, North Campus School of Justice 11380 NW 27th Avenue

Miami, Florida 33167-3495

(305) 237-1400