Name *

First Name

Last Name

Phone *

(###)

###

####

*

I have read and acknowledge the contents of the New Member Agreement

If you were referred by a co-worker, please enter their name so they can receive proper credit.

Referred By

First Name

Last Name

Have you been involved in a 998 in the last year? *

Yes

No

Have you been involved in a CAT III UOF in the last year? *

Yes

No

Have you been notified that you are the subject of a pending IAB investigation? *

Yes

No

Have you been advised that a POE has been filed against you in the last year? *

Yes

No

Have you been ROD in the last year? *

Yes

No

Have you been benched in the last year? *

Yes

No

Have you been placed on Performance Review or Peer Mentoring in the last year? *

Yes

No

Have you been involved in an on-duty TC in the last year? *

Yes

No

I have read and acknowledge the contents of the New Member Agreement

Rank: You Must Select One *

Deputy Sheriff—-$85

Sergeant—-$95

Lieutenant—-$105

Captain--$115

Custody Assistant--$65

Law Enforcement Technician--$55

Security Officer--$45

Security Assistant--$40

Professional Staff (varies by item number, please enter your item number below)

Sheriff's Reserve Deputy--$225 per year or $60 for 3 months

Other

Yes, I agree to the above terms and conditions.