Sheriff's Citizens Academy Online Application
(EOC) September 12th - November 7th 2019 Afternoon 1-4pm
(EOC) September 12th - November 7th 2019 Evening 6-9pm
EOC - 18900 Cortez Blvd, Brooksville
Atria - 7030 Evergreen Woods Trail, Spring Hill
Full Legal Name:
Any Other Names you
have been known by:
City / State / Zip:
Social Security Number:
Driver's License Number:
Drivers License State:
Drivers License Exp:
Have you ever been arrested?
If YES, list the charges
Date of Birth:
If you have any specific questions that are not addressed on this form or experiencing issues submitting this form, please contact Kim Purchase, Community Outreach Coordinator 352-797-3678.
By clicking submit you certify that:
1. The information supplied in this application is true and correct to the best of your knowledge.
2. You grant the Hernando County Sheriff's Office permission to verify all information provided.
3. You are aware that a criminal history will be conducted by the Hernando County Sheriff's Office.
4. A denial of this application may occur if any false statements or misrepresentation of any facts are noted in the process.
5. If any blanks appear on the application it will not be considered.