Corrections Officer Academy Registration Form "*" indicates required fields APPLICANT INFORMATIONLCOTS#* SSN (last 4 digits)* Name* First Last Previous Last Name(s)Please list any previous last names (maiden, married, etc. — optional) Home Address* Street Address 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 Applicant Email Address* Birthdate*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender* Male Female Are you being sponsored by an agency?* Yes No DEPARTMENT INFORMATIONDepartment* Department Email Address* Department Training Authorized By* ACADEMY COSTWhich academy session would you like to attend?* September 3-27, 2024 Corrections Officer Academy (WFD26007, F24) Price: Total PAYMENTHow will you be making payment — mailing a check or contacting Student Financial Services with credit card information?Payment Method* Check Credit Card This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.CommentsThis field is for validation purposes and should be left unchanged.