San Bernardino County Sheriff's Department Volunteer Forces
 
PLEASE PRINT OR TYPE ALL INFORMATION

Mail to: Volunteer Forces Unit, 655 E. 3rd St. San Bernardino, CA 92415

Station/Division applying for: _____________________________________________
Select one of the programs below...
.
 [ ] Citizen Volunteer/Citizen Patrol*  [ ] Search and Rescue - Peace Officer**
 [ ] Line Reserve** (Peace Officer Only )  [ ] Search and Rescue - Citizen Volunteer*
 [ ] Explorer Scout program  [ ] Mounted Posse - Peace Officer**
 [ ] Specialized Unit (specifiy which)  [ ] Mounted Posse - Citizen Volunteer*
* Citizen Volunteers must be at least 18 years old
** Reserve Peace Officers must be at least 21 years old and a U.S. citizen at time of
appointment, or an eligible candidate for citizenship

1. Name ___________________________________________________________________

Address ___________________________________________________________________

City _____________________________________ State: _____________Zip: ___________

Home Phone: __________________________ Work Phone: ___________________________

Social Security # ________ - _______ - _____________

CA Driver's License # ___________________________ Expires _________________

2. Have you ever applied to this Department for a position before? [ ] Yes [ ] No

If yes, explain: _______________________________________________________________

3. Have you ever been [ ] Arrested [ ] Convicted of a Felony [ ] Convicted of a Misdemeanor?
Have you ever been fingerprinted? [ ] Yes [ ] No

4. Education (Circle highest grade completed) High School: 9 10 11 12 College: 13 14 15 16
Do you have: [ ] High School Diploma [ ] GED Certificate

5. Reserve Training [ ] Level I [ ] Level II [ ] Level III [ ] Module D [ ] Basic Academy (Check highest level completed)

I hereby authorize the San Bernardino County Sheriff's Department to conduct a background investigation concerning my
work reputation, medical, physical, and criminal records, including information of a confidential or privileged nature.

Signature __________________________________________________ Date ___________________