F.R.I.D.A.Y.

INSTRUCTOR APPLICATION

(PLEASE COMPLETE AND HIT THE SUBMIT BUTTON AT THE BOTTOM OF THE PAGE)

EMAIL ADDRESS (required):
FIRST NAME:
LAST NAME:
AGENCY NAME:
AGENCY ADDRESS:
AGENCY PHONE NUMBER:
DIRECT LINE or EXT:
MOBILE NO.:
PREFERRED HOURS FOR RECEIVING TELEPHONE CALLS:
CURRENT RANK:
NO. OF SERVICE YEARS AS A PEACE OFFICER:
NO. OF YEARS AS A TCLEOSE CERTIFIED INSTRUCTOR:
PID NUMBER:
DOB:
DRIVERS LICENSE NUMBER:

Please answer the following written questions in as much detail as possible.

1. DESCRIBE ANY EXPERIENCE THAT YOU HAVE HAD IN PUBLIC SPEAKING OR TRAINING:

2. BRIEFLY DESCRIBE YOUR COMPUTER SKILLS, ESPECIALLY WITH MICROSOFT WORD AND POWERPOINT:

3. TCLEOSE LICENSE CERTIFICATIONS: (PLEASE CHECK ALL THAT APPLY)

BASICINTERMEDIATEADVANCEDMASTERINSTRUCTORSPECIAL INVESTIGATOR

4. LIST ANY OTHER CERTIFICATIONS OR TRAINING PERTINENT TO THIS SUBJECT:

5. ARE YOU SERVING AS A RESERVE OFFICER/DEPUTY?

YESNO

6. BRIEFLY ELABORATE ON YOUR INTEREST AND EXPERIENCE IN THE FIELD OF UNDERAGE DRINKING AND UNDERAGE IMPAIRED DRIVING:

7. HOW LONG HAVE YOU BEEN A TRAINER/INSTRUCTOR FOR LAW ENFORCEMENT?

8. PROVIDE ANY REFERENCES WHO WOULD CONSIDER YOU A POSITIVE ROLE MODEL WITHIN YOUR DEPARTMENT AND COMMUNITY:

9. HAS YOUR PEACE OFFICER’S LICENSE EVER BEEN SUSPENDED OR REVOKED?

YESNO IF YES, PLEASE EXPLAIN:

10. ARE YOU CURRENTLY IN COMPLIANCE WITH THE PEACE OFFICER CONTINUING EDUCATION REQUIREMENTS?

YESNO IF NO, PLEASE EXPLAIN:

11. PLEASE LIST ANY COMMENDATIONS, PROCLAMATIONS OR AWARDS THAT YOU HAVE RECEIVED WHILE IN THE FIELD OF LAW ENFORCEMENT:

12. HAVE YOU ATTENDED AN 8-HOUR F.R.I.D.A.Y. CLASS? (Not a Requirement)

YESNO IF YES, LOCATION & DATE:

13. ARE YOU A MEMBER OF A COALITION IN YOUR COMMUNITY? (Not a requirement and not limited to coalitions that are focused on underage drinking)

YESNO IF YES, NAME: