Form F-7 Application for Certification - Alaska

Form F-7 is a Alaska Department of Public Safety form also known as the "Application For Certification". The latest edition of the form was released in June 8, 2017 and is available for digital filing.

Download an up-to-date Form F-7 in PDF-format down below or look it up on the Alaska Department of Public Safety Forms website.

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Alaska Police Standards Council
F-7
APPLICATION FOR CERTIFICATION
PO Box 111200
Juneau, AK 99811-1200
Ph: 907 465-4378
CHECK ONE:
CHECK ONE:
Police
Correctional
Probation/Parole
Basic
Intermediate
Advanced
Village Police
Last, First, Middle
1.
Name (
)
2.
Social Security Number
3.
Date of Birth
4.
Sex
5.
Home Address (
Street, City, Zip
)
6.
Personal E-mail:
7.
Personal Phone:
CRIMINAL JUSTICE EXPERIENCE:
Dates of Employment
if more space is needed, use page 2
(
.)
list present agency first
8.
Agency (
)
Address
To
From
Highest Rank
CRIMINAL JUSTICE TRAINING:
if more space is needed, use page 2
(
.)
Course Hours
Date Completed
9.
Course
Sponsor
ACADEMIC EDUCATION:
(
provide official college transcript if application is for Intermediate or Advanced Certificate
.)
10. High School
Location
Dates Attended
Diploma
GED
State
11. College
Location
Major
Dates Attended
Credit Hrs. or
Degree
12. Have you ever been arrested?
YES
NO
Have you ever been discharged, asked to resign, or involuntarily terminated from
employment?
YES
NO
If answer is YES to either question, show date, disposition, reason and by whom on the 2
nd
page of
this application form.
I swear and attest that I am a citizen of the United States; I have read and subscribed to the Enforcement Code of Ethics or the Alaska
Department of Corrections Code of Ethics; I have been employed full-time for the past twelve months with my present employer, if I am
applying for a basic certification; and, that I acknowledge the information contained on this form will be used by the council for purposes of
determining my eligibility and qualifications for training, employment, and certification.
I certify under penalty of PERJURY that the foregoing is true and accurate to the best of my knowledge.
Done at___________________________, Alaska on the ______________day of ________________________________, 20_______.
__________________________________________
SWORN TO AND SUBSCRIBED BEFORE ME
Applicant
this___________day of_____________________, 20_______.
__________________________________________________
Notary Public in and for Alaska
My Commission Expires: ______________________________
CHK#: ___________
APSC 6/08/2017
1
Alaska Police Standards Council
F-7
APPLICATION FOR CERTIFICATION
PO Box 111200
Juneau, AK 99811-1200
Ph: 907 465-4378
CHECK ONE:
CHECK ONE:
Police
Correctional
Probation/Parole
Basic
Intermediate
Advanced
Village Police
Last, First, Middle
1.
Name (
)
2.
Social Security Number
3.
Date of Birth
4.
Sex
5.
Home Address (
Street, City, Zip
)
6.
Personal E-mail:
7.
Personal Phone:
CRIMINAL JUSTICE EXPERIENCE:
Dates of Employment
if more space is needed, use page 2
(
.)
list present agency first
8.
Agency (
)
Address
To
From
Highest Rank
CRIMINAL JUSTICE TRAINING:
if more space is needed, use page 2
(
.)
Course Hours
Date Completed
9.
Course
Sponsor
ACADEMIC EDUCATION:
(
provide official college transcript if application is for Intermediate or Advanced Certificate
.)
10. High School
Location
Dates Attended
Diploma
GED
State
11. College
Location
Major
Dates Attended
Credit Hrs. or
Degree
12. Have you ever been arrested?
YES
NO
Have you ever been discharged, asked to resign, or involuntarily terminated from
employment?
YES
NO
If answer is YES to either question, show date, disposition, reason and by whom on the 2
nd
page of
this application form.
I swear and attest that I am a citizen of the United States; I have read and subscribed to the Enforcement Code of Ethics or the Alaska
Department of Corrections Code of Ethics; I have been employed full-time for the past twelve months with my present employer, if I am
applying for a basic certification; and, that I acknowledge the information contained on this form will be used by the council for purposes of
determining my eligibility and qualifications for training, employment, and certification.
I certify under penalty of PERJURY that the foregoing is true and accurate to the best of my knowledge.
Done at___________________________, Alaska on the ______________day of ________________________________, 20_______.
__________________________________________
SWORN TO AND SUBSCRIBED BEFORE ME
Applicant
this___________day of_____________________, 20_______.
__________________________________________________
Notary Public in and for Alaska
My Commission Expires: ______________________________
CHK#: ___________
APSC 6/08/2017
1
RECOMMENDATION:
It is recommended that the above applicant be certified. I certify under penalty of perjury that the applicant has complied with
the minimum standards established pursuant to AS 18.65.240 or AS 18.65.242, is of good moral character and is worthy of
certification. My opinion is based upon personal knowledge or inquiry and the personnel records of this jurisdiction
substantiate the recommendation.
Department/Agency Head Signature_______________________________________________
Date________________
Please attach payment (made out to APSC) in the amount of 50.00 for each certificate.
APSC USE
APSC Approval
Type Certificate
Date Approved
SECTION
ADDITIONAL INFORMATION OR COMMENTS
NUMBER
APSC 6/08/2017
2

Download Form F-7 Application for Certification - Alaska

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