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Citizen Police Academy

  1. B AND W SHERIFF STAR

  2. Ontario County Sheriff's Office

    Citizen Police Academy

  3. Please be sure to fill out completely before clicking "Submit". Partially completed applications may require re-submission before being considered valid. ***NOTICE - By checking the eSignature/Consent box and submitting this application, you give consent to the Ontario County Sheriff's Office to conduct a background check to include a criminal history clearance on my name and I am providing the above information on a voluntary basis with the understanding that it shall be used to perform such clearance.

  4. Candidate Name

  5. Enter "None" or NA if not applicable

  6. Street # only

  7. Street name only

  8. Street, Avenue, etc.

  9. If applicable

  10. MM/DD/YYYY

  11. ###-##-####

  12. ###-###-###

  13. Telephone Numbers

  14. Phone 1*

    Please Choose one

  15. Phone 2

  16. Phone 3

  17. Due to the nature of Law Enforcement information that may be disseminated in this Academy, it is necessary to restrict enrollment to only those persons who have not been convicted of any crime in the past five (5) years.

  18. eSignature/Consent

    I do hereby give my consent to the Ontario County Sheriff's Office to conduct a background check to include a criminal history clearance on my name and I am providing the above information on a voluntary basis with the understanding that it shall be used to perform such clearance. The conviction of a serious felony may prevent your participation in the Citizen Police Academy.

  19. Signature:______________________________________________________________________________

    If submitting via email, please check the "Consent to background check" checkbox above

  20. Date: _______________________

  21. Parent Signature (if less than 18 years of age):

  22. Parent signature (if less than 18 yo)____________________________________________________________________

    If submitting via email, please check the "Consent to background check" checkbox above and send a written and signed letter with your child to the first class

  23. Return Application to:

    Ontario County Sheriff's Office Attn: Krista Schlenker (585-396-4663)
    email: KristaLS@Co.Ontario.NY.US
    74 Ontario Street
    Canandaigua, NY 14424-1898

  24. Please be sure to fill out completely before clicking "Submit and Print" or "Submit". Partially completed applications may require re-submission before being considered valid.

  25. Leave This Blank:

  26. This field is not part of the form submission.