Mounted Posse Application - Linn County Sheriff's Office

Identification

Name*

First Middle Last

Date of Birth*

Social Security Number (SSN)*

Driver's License Number*

State of Issue*

Contact Information

Home Address*

Street Address Address Line 2 City State ZIP Code

Mailing Address (if different)

Street Address Address Line 2 City State ZIP Code

Email Address*

Home Phone*

Work Phone

Mobile Phone

Other Names Used

Emergency Contact

Name*

First Last

Phone*

Alternate Phone

Personal References

First Reference

First Middle Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Second Reference

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Additional Information

Current Occupation

Have you ever been arrested for any criminal offense?*

no
yes

Please explain the circumstances of your arrest:

Mounted Posse Information

Do you own a horse?

Age

Breed

Color

Height

Weight

Do you have transportation for your horse?

yes
no

Truck Type

Trailer Type

Do you own a sidearm?

yes
no

Make

Caliber

Finish

Are your personal and business affairs such that you will be able to attend the majority of the posse drills, meetings and functions?

yes
no

Have you read and are you willing to conform to the aims, requirements and responsibilities of membership?

Please carefully read the Mounted Posse Requirements and Responsibilities before answering this question.

yes
no

All new members accepted into the Linn County Sheriff's Mounted Posse are required to become Search and Rescue (SAR) certified within 12 months of being accepted into the Posse. Are you willing to meet this requirement?

yes
no

Please tell us your reasons for desiring to become a member of the Linn County Sheriff's Mounted Posse:

Signature and Certification

Certification*

I have read the entire text of this application and understand it completely. The statements I have made are correct and true. I understand that making false statements on this application is a crime. If I have made false statements in this application, I am subject to prosecution and my application will automatically be denied or revoked.

I certify that I intend my electronic signature on this application to be the legally binding equivalent of my traditional handwritten signature.

Signature*

Enter your full legal name.

Date Signed*

Phone

This field is for validation purposes and should be left unchanged.