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Homeland Protection Certification Application

Please complete the following form to continue:
* = required fields

Applicant Information

First Name:*

Middle Name/Initial:

Last Name:*

Gender:*

Email:*

Phone:*

Agency / Company Information:

Title / Rank:

Agency / Company:*

Address:*

City:*

State:*

Zip code:*

Country:*

Business Phone Number:*

Preferred Postal Mailing Information

(If same as above, please enter "SAA" for the address.)

Address:

City:

State:

Zip code:

Country:

Certification Request

Certification Applied for:*

Member ID# :

Current Status:*

If other, please indicate:

Current Employer or School

Employer or School Name:*

Address (Street #):*

City:*

State:*

Zip Code:*

Supervisor Name or Contact for Verification:*

Contact Phone #:*

Required Documentation

Proof of Required Course Work:*
Upload PDF or JPG files or email your documents to training@sheriffs.org
NOTE: File uploads may not be supported by your Safari / IOS devices. Please email your files instead.
(Limit: 5MB PDF or JPG files)

Would you like to upload a file?yesno

Proof of Citizenship:*
Upload PDF or JPG files or email your documents to training@sheriffs.org
NOTE: File uploads may not be supported by your Safari / IOS devices. Please email your files instead.
(Limit: 5MB PDF or JPG/PNG files)

Demographic Information:

Education:*

(Please specify highest level completed)

Have you ever been convicted of a crime (or in military service convicted by a general court martial) or is there any criminal charge now pending against you?*YesNo

If the answer is "Yes", please explain.
This information will not be circulated outside the Certification Board. An affirmative answer does not necessarily mean rejection of your application. (Please omit offenses committed before your 18th birthday.)

Explanation:

Have you ever had a professional membership, license, registration, or certification denied, suspended, or revoked (other than a lack of minimum qualification or failure of examination)?*YesNo

Explanation:

If separated from the U.S. Military, did you receive an honorable discharge?YesNo

Upon successful completion of the form, please go to the on-line payment options.

$50.00 of the certification fee is a non-refundable processing fee.

NOTE: If your form submission just hangs, please remove attachments. Your device does not support file attachment submissions. Email your documents to us instead.