Application Home > Application K.C.L.E.F Membership Application Application Type*Please SelectNew MembershipRenew MembershipAre you a PEACE OFFICER?*Please SelectYesNoPeace Officer status as defined in Chapter 4.5 (commencing with Section 830) of Title 3 of Part 2 of the Penal Code, who has successfully completed a course of study in the exercise of the power to arrest approved by POST is exempt from completing the Bureau-related power to arrest training [BPC Sections 7542 and 7583.6(g)].Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Social Security #* Driver License #* Residence Phone #*Business Phone #*Email* Occupation* Employed By* Company NameBusiness Address Business Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth* MM slash DD slash YYYY Place of Birth* Height(Feet)0'4'5'6'7'Height(Inches)0"1"2"3"4"5"6"7"8"9"10"11"12"Weight Hair ColorBLK - BlackWHI – WhiteBRO – BrownGRY – GrayBLN – BlondeBAL – BaldRED – RedSDY – SandyUNK – UnknownEye ColorBLK – BlackGRN – GreenBLU – BlueHAZ – HazelBRO – BrownPNK – PinkGRY – GrayUNK – UnknownDIC – DichromaticApplicant Recommended ByApplicant Recommended By: (must be member of good standing) NEXT OF KINName* First Last Relationship Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employed By* Company NamePhone NumberPhone Number Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code As a member of the Kern County Law Enforcement Foundation, I understand this does not authorize me any Peace Officer powers or permission to carry a firearm. Any misuse of my identification shall result in my immediate termination. I understand the identification issued shall remain the sole property of the Kern County Law Enforcement Foundation. Upon termination of Membership, I agree to surrender my identification card. I understand that the annual dues for the Foundation are $100, and are not refundable after acceptance as a member. The dues are for the calendar year in which paid, with the exception that dues paid in the last calendar quarter of the year will be from that date until the end of the next calendar year. Having made application to become a member of the Kern County Law Enforcement Foundation, I hereby authorize the Kern County Sheriff’s Department to conduct a thorough background investigation. This could include investigate any arrests, traffic citations and accident reports, credit records, criminal justice records, law enforcement detentions and interviews, and any other information source that could be used to determine my character. Electronic Signature* By checking this box and typing my name below, I am electronically signing my application and I agree to the Terms and Conditions. Enter Electronic Signature First Middle Last Date* MM slash DD slash YYYY Date Δ
