BCA Application - Livingston Parish Sheriff's Office

Application

Select Class Preference(Required)

Name of Agency(Required)

Agency Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Agency Contact(Required)

Agency Contact Phone Number(Required)

Agency Contact Email Address(Required)

Applicant Information

Name (as it appears on your driver's license)(Required)

First Middle Last Suffix

Gender(Required)

Date of Birth(Required)

Applicant Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Applicant Email Address (Department Email)(Required)

Social Security Number(Required)

Applicant Cell Number(Required)

Alternative Phone Number

Age(Required)

Shirt Size(Required)

Height(Required)

Weight(Required)

Weapon(Required)

Model(Required)

Caliber(Required)

Brief Description of Law Enforcement Experience(Required)

Do you have any physical limitations, injuries, or conditions which prevent unrestricted, regular participation in FIREARMS TRAINING OR DEFENSIVE TACTICS*(Required)

(Including takedowns, handcuffing procedures, impact weapon use, running, etc.)

Yes

If you answered YES above, please provide specific details of limitations or injuries. Otherwise enter "N/A"*(Required)