Ala. Admin. Code 650, app F
PEACE OFFICERS STANDARDS AND TRAINING COMMISSION
Instructor Certification Application
SUBJECT:
_______________________________________________________________
Name
__________________________________________________________________
Last First Middle S.S. Number
Date of Birth _____________ Race __________ Sex
_____________________________
Place of Birth
__________________________________________________________
City State County
NAME OF ACADEMY THAT YOU WILL BE INSTRUCTING AT:______________________________
APOST Certified ___ / ___ PLEASE MARK BELOW WHICH TYPE OF CERTIFICATION
Yes No THAT YOU HAVE BEEN ISSUED FROM THIS AGENCY:
APOST Basic Police Training Graduate ....... ___ / ___ / __________________
Yes No Certificate Number
APOST Basic Corrections Training Graduate .. ___ / ___ / __________________
Yes No Certificate Number
APOST Grandfather .......................... ___ / ___ / __________________
Yes No Certificate Number
APOST Waiver ............................... ___ / ___ / __________________
Yes No Certificate Number
APOST Instructor ........................... ___ / ___ / __________________
Yes No Certificate Number
*******************************************************************************
Current Employment:
Agency____________________ Date Hired
_________________________________________
Rank or Title
_________________________________________________________________
Present Assignment or Position
________________________________________________
LAW ENFORCEMENT OR RELATED EXPERIENCE:
Agency and Unit Assignment
1.
____________________________________________________________________________
2.
____________________________________________________________________________
3.
____________________________________________________________________________
LAW ENFORCEMENT TRAINING: (attach extra pages if necessary)
School Name and Course Title and Hours Taken
_______________________________________________________________________________
_______________________________________________________________________________
TOPIC
________________________________________________________________________
HOURS
_______________________________________________________________________
PURPOSE_____________________________________________________________________
OBJECTIVE:
METHODOLOGY:
lectures __________
films __________
handouts __________
other __________
LESSON OUTLINE:
(major points)
EVALUATION: (5-7 questions with correct answers that can be incorporated into an over-all test on entire course.)
BIBLIOGRAPHY:
Alabama Peace Officers Standards and Training Commission's Instructor Application
Ala. Admin. Code 650, app F