Tuolumne County Sheriff’s
SEARCH & RESCUE
Area of Primary Interest (check one)
? CanineTeam ? Mounted Team
? Swiftwater Team ? Underground Team
? Nordic Team ? Technical Rescue Team
? Medical Team ? Helicopter Rescue Team
? Motorized Unit ? Dive/Recovery Team
Fill in as completely as possible. Type or print clearly.
Last __________________________________ First _________________________ Middle ____________________________
Other names (maiden, prior, aliases, nicknames) _____________________________________________________________
Date of Birth (MO/Day/Yr) ____________________ Age ________ SSN ________________
Sex ___ Height _________ Weight ____________ Hair ___________ Eyes _____________
Address ________________________________ Apt. _____________ City_______________________ ZIP ___________
Home Phone (____)_______________ Work Phone (____)_______________ Pager (____) _________________
Address __________________________ Apt. _____________ City______________ ZIP ________________
Home Phone (____) _________________ Work Phone (____) _________________ Pager (____) _________________
Return completed application to:
Tuolumne County Sheriff’s Search & Rescue
28 N. Lower Sunset Dr.
Sonora, Ca 95370
You must be a citizen of the United States or a permanent resident alien, who is eligible for and has applied for citizenship.
Place of birth _________________________________________________________________________ City/State/Country
Are you a U.S. Citizen? ? Yes ? No
If naturalized, what year and where? ____________________________________________________________________
If you are a permanent resident alien, what is your registration number? _________________________________________
Have you applied for citizenship? ? Yes ? No
When did you apply for citizenship? ________________________________
? Single ? Married ? Separated ? Divorced ? Widowed
Number of marriages______ Number of children_____ Number of children living at home ______
Are you child support and/or alimony payments current? ? N/A ? Yes ? No
If “no” please explain on page 10.
? I do not have a high school diploma.
? I have a high school diploma. I graduated in __________ from _________________ High School
Mo/Yr Name of School
Located in __________________________
? I have a G.E.D. or California High School proficiency certificate. I received my G.E.D./CHSP in
? __________________from _______________________________ located in ____________________________.
Mo/Yr Name of school/testing center City/State
? I have no college education.
? I have no college degree
? I have a college degree(s). I graduated in___________. My degree(s) is/are (circle) A.A., A.S., B.A.,
B.S., M.A., M.S. degree. I majored in ______________________________________________
While attending __________________________________________________ College(s)
Located in ________________________
1. Do you have a valid California Driver’s License? (CDL) ? Yes ? No
CDL number ________________________________ Expiration date _______________________________
2. Have you ever had an out-of state license?
What state(s)? ________________________________ What years? _________________________________
Current out-of-state license number ____________________________
3. Has your license ever been suspended, restricted, revoked, or placed on probation? ? Yes ? No
If “yes”, explain when and why on page 9.
4. Other than a parking ticket, how many tickets have you received in the last five years? _____________________
Explain on page 9.
5. Do you have any citations or parking tickets that are past due or pending? ? Yes ? No
If “yes”, explain on page 9.
6. Have you been involved as a driver in a traffic accident within the last five years? ? Yes ? No
If “yes”, explain on page 9.
7. Do you currently have automobile insurance? ? Yes ? No
Insurance carrier _________________________________
If “no”, explain why, and how long you have driven without insurance, on page 9.
1. Have you ever been detained, questioned, held on suspicion, fingerprinted or taken into custody, by any law
enforcement agency, for any reason other than a minor traffic ticket? ? Yes ? No
2. Have you ever been a suspect in any law enforcement investigation? ? Yes ? No
3. Have you ever been charged with a crime? ? Yes ? No
4. Have you ever been arrested? ? Yes ? No
5. Have you ever been in jail? ? Yes ? No
6. Have you ever been convicted or pled guilty to any crime? ? Yes ? No
7. Have you ever collected unemployment or welfare benefits (including food stamps),
when you were not entitled? ? Yes ? No
8. Since you were 18 years old, have you ever shoplifted anything from a store? ? Yes ? No
9. Have you ever been involved in a fight? ? Yes ? No