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Print Form MIAMI POLICE TRAINING CENTER Room 327 400 NW 2 Avenue Miami Florida 33128 Office 305 603-6624 Fax 305 579-6143 STUDENT APPLICATION FORM Submit a thoroughly completed student application by the closing date if applicable as indicated on the Training and/or website www. miami-police. org. All student applications are subject to inspection in accordance with the provisions Announcement of State of Florida Public Records Act. Select the appropriate Application category Region XIV Complete Personal Info A B C Work Info Only Basic Law Enforcement Complete first page only Internship Program Complete all pages Auxiliary Police Officer Complete first page only Public Service Aide Complete first page only Entrepreneurial Complete first page only Other Complete first page only COURSE/CLASS DATE PERSONAL INFORMATION A Last Name First Name Rank/Classification Race M. I. Date of Birth Sex Height B Social Security City Work Telephone WORK INFORMATION Place of Employment Employer Telephone Eye Color Hair Color Driver License Home Address C Home Telephone Place of Birth Work Address D/L State State Zip/Postal Code Unit/Section Assignment Home Email Supervisor s Name Work Email Supervisor s Email VEHICLE INFORMATION Make of Vehicle Year of Vehicle Type of Vehicle Color of Vehicle Vehicle Insurance Company Policy Applicant Signature Date Approved for Mandatory Training Salary Incentive Outside Agency Supervisor Print Name Sign Name // Do not write/mark below this line. STAFF USE ONLY Application Completed YES NO Training Coordinator Signature Date // Not Recommended NOTES. miami-police. org. All student applications are subject to inspection in accordance with the provisions Announcement of State of Florida Public Records Act. Select the appropriate Application category Region XIV Complete Personal Info A B C Work Info Only Basic Law Enforcement Complete first page only Internship Program Complete all pages Auxiliary Police Officer Complete first page only Public Service Aide Complete first page only Entrepreneurial Complete first page only Other Complete first page only COURSE/CLASS DATE PERSONAL INFORMATION A Last Name First Name Rank/Classification Race M. Select the appropriate Application category Region XIV Complete Personal Info A B C Work Info Only Basic Law Enforcement Complete first page only Internship Program Complete all pages Auxiliary Police Officer Complete first page only Public Service Aide Complete first page only Entrepreneurial Complete first page only Other Complete first page only COURSE/CLASS DATE PERSONAL INFORMATION A Last Name First Name Rank/Classification Race M. I. Date of Birth Sex Height B Social Security City Work Telephone WORK INFORMATION Place of Employment Employer Telephone Eye Color Hair Color Driver License Home Address C Home Telephone Place of Birth Work Address D/L State State Zip/Postal Code Unit/Section Assignment Home Email Supervisor s Name Work Email Supervisor s Email VEHICLE INFORMATION Make of Vehicle Year of Vehicle Type of Vehicle Color of Vehicle Vehicle Insurance Company Policy Applicant Signature Date Approved for Mandatory Training Salary Incentive Outside Agency Supervisor Print Name Sign Name // Do not write/mark below this line..

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