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#21-004126-0003
Supplemental Questionnaire

Last Name
First Name

 

**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

 


1.

Are you currently certified as a law enforcement officer by the Maryland Police and Correctional Training Commission?

Yes No
 

If yes, please provide your MPCTC certification number and expiration date. Please upload a copy of your certification to this application. If you are not currently certified, type N/A in the box below.

2.

If you are not currently certified as a law enforcement officer, with MPCTC, but were certified in the last three years, please provide the name and contact information for your previous employer.


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