Law & Order Application
THE AMERICAN LEGION - DEPARTMENT OF VERMONT
 PO BOX 396, MONTPELIER, VT 05601-0396
 TEL: (802) 223-7131     FAX: (802) 223-0318          E-mail: alvthq@verizon.net

THE AMERICAN LEGION AND CRIMINAL JUSTICE TRAINING COUNCIL APPLICATION
VERMONT POLICE ACADEMY - PITTSFORD, VERMONT
JUNE 22 THROUGH JUNE 27, 2008.

APPLICATION: (To be completed personally by applicant. Please TYPE or PRINT IN INK)

________________________________________________________________________
Last Name          First Name          Middle Initial

________________________________________________________________________
Age               Date of Birth (Month/Day/Year)                    Sex

________________________________________________________________________
Address (Street, City, State & Zip)

________________________________________________________________________
Father's Name & Address

________________________________________________________________________
Mother's Name & Address

________________________________________________________________________
Name & Location of School

________________________________________________________________________
Activities (School, Sports, Church, Clubs, Civic, etc.)

TRANSPORTATION: Cadets to provide their own transportation. For those Cadets wishing to drive their vehicles to the Academy, parking space will be available. However, the vehicle must remain parked until checkout time on Friday.

CHECK-IN: At the Vermont Police Academy, Pittsford, VT at 5:00 p.m. on SUNDAY, JUNE 22, 2008.  PIZZA WILL BE SERVED.  See attached map for directions to the Academy.

GRADUATION: Family & Friends of the Cadets are invited to attend a short Graduation exercise, which will take place at 1:30 p.m. on FRIDAY, JUNE 27, 2008.

Every application must be of good moral character and come well recommended.

All completed applications, along with an American Legion Post cheek for $150.00 must be returned to THE AMERICAN LEGION OF VERMONT, PO BOX 396, MONTPELIER, VT 05601-0396 -- NOT LATER THAN MAY 15, 2008.

13. I do believe in The American Legion's principles of Law & Order.

DATE:  _____________   SIGNATURE OF APPLICANT:  _____________________________     

MEDICAL CERTIFICATE:
(The following must be completed and submitted with your application.)

_________________________________________________________________
Last Name               First Name               Middle Initial
_________________________________________________________________
Address (Street, City, State & Zip)
_________________________________________________________________
Relative's Name & Phone Number (person to be notified in case of an emergency.)

DISEASES you have had.  Please place an "X" beside all that apply.
____ MEASLES                            ____ TYPHOID FEVER          ____ ASTHMA
____ EAR / SINUS TROUBLE     ____ CONVULSIONS             ____ SCARLET FEVER
____ PNEUMONIA                        ____ DIPHTHERIA                  ____ LUNG TROUBLE
____ SMALL POX                         ____ HEART TROUBLE          ____ DIABETES
____ CHICKENPOX                      ____ POLIO                             ____ APPENDICITIS
____ MUMPS                                ____ INDIGESTION
____ ALLERGIES - Please List

5. Date of Last Tetanus Shot:  _________________________________________________
6. Have you been vaccinated against Smallpox? __YES          ____ NO
7. List PRESCRIPTION MEDICATION that you are currently using:
_______________________________________________________________


_____________     ____________________________________________________
DATE                               SIGNATURE OF APPLICANT

8. MUST BE COMPLETED BY FAMILY PHYSICIAN.

Does the applicant suffer from any of the following?
____ ASTHMA                ____ SINUS                           ____ BRONCHITIS
____ HAY FEVER          ____ HEART TROUBLE     ____ DIABETES

Does the applicant require medication or special diet?  ___________________________________

Is the applicant in physical condition to undergo a week of strenuous physical and mental activity?
_____________________________________________________________________

Condition of the following:       __________ Heart          __________ Eyes
__________ Lungs          __________ Throat


________________         _______________________________________________
DATE                                          SIGNATURE PHYSICIAN

_____________________________________________________________________
Address of Physician






MEASUREMENTS:      T-Shirt SIZE:  _____ SMALL  ____ MEDIUM  ____ LARGE  ____ X-LARGE
PANT-SIZE:     __________ WAIST            __________ INSEAM
__________ HEIGHT          __________ LBS. (Weight)


ENDORSEMENTS

SCHOOL: (To be completed by High-School Principal.) I hereby certify that at the time this application is being completed, the student is a member of the ____ Junior or ____ Senior Class at
________________________________________________________High School, and is at least 16 years of age, I recommend his/her participation in the Cadet Law Enforcement Program, co-sponsored by The American Legion and The Vermont Criminal Justice Training Council.

__________________          ______________________________________________________
DATE                                       SIGNATURE OF HIGH SCHOOL PRINCIPAL


LAW ENFORCEMENT OFFICIAL: (To be completed by a full time Law Enforcement Officer). I,
______________________________________________, regularly employed in the field of law enforcement, do know and have interviewed the applicant and do hereby recommend him/her as a worthy candidate to participate in the youth program.  He/She does/does not have a valid Vermont Drivers License.

__________________          ______________________________________________________
DATE                                       SIGNATURE / OFFICIAL TITLE / DEPARTMENT


LEGION POST: (To be completed by the Post Commander or Adjutant). I hereby certify that the above applicant is a resident of our Post Community and our Legion Post recommends that he/she be accepted as a delegate at the Cadet Law Enforcement Academy. The Post Check for $150.00 fee is enclosed with this application and is made payable to The American Legion Department of Vermont.

__________________          ______________________________________________________
DATE                                        SIGNATURE LEGION POST OFFICER/POSITION



FOR THE PARENT OR GUARDIAN: It is important that the home phone number of the Cadet be placed on the application form so parents/guardians may be reached in case of emergency. In addition, the Medical Certificate must be filled out and signed by a physician. Cadets will not be excused before the close of the session except in the case of an emergency, such as illness of the Cadet or illness or death in the Cadet's immediate family.

I hereby authorize the Vermont Criminal Justice Training Council Staff or their representative to obtain medical treatment for my Son/Daughter/Ward, _____________________________________, while participating in The American Legion Law & Order Cadet Training Program, June 22nd - June 27th, 2008.  Said treatment may include medication, injection, and/or emergency surgical treatment.

__________________          ______________________________________________________
DATE                                       SIGNATURE OF PARENT/GUARDIAN





9. WAIVER OF LIABILITY

     I, __________________________________________________________, being the parent/legal guardian of ______________________________________________________ in consideration of his /her attendance at The American Legion Law & Order Cadet Training Program to be held at The Vermont Police Academy, do agree that the State of Vermont, The Vermont Criminal Justice Training Council, The Vermont Police Academy and The American Legion Department of Vermont, or any of their employees, will not be held responsible for any injury or damage received or caused to themselves, to include, but not limited to the Ropes Course, Firing Range and Gym Facilities, by their participation in this program.
     The agreement becomes effective June 22, 2008 and shall remain in effect until close of business on June 27, 2008.

__________________          ______________________________________________________
DATE                         SIGNATURE OF PARENT/GUARDIAN

______________________________________________________
PRINT NAME

__________________          ______________________________________________________
DATE                         WITNESS


THE AMERICAN LEGION/VERMONT CRIMINAL JUSTICE TRAINING COUNCIL
VERMONT POLICE ACADEMY, PITTSFORD, VERMONT
GROOMING CODE!!



The Vermont American Legion sponsors a number of Americanism Programs for the Youth of Vermont. These programs are: Green Mountain Boys State, American Legion Baseball, American Legion High School Oratorical Contests and The Cadet Law Academy, co-sponsored by the Vermont Criminal Justice Training Council. The principle reason for sponsoring these youth programs is to help the home, school, and church to teach the youth of today to become better citizens for tomorrow.

Since The American Legion Department of Vermont and the Vermont Criminal Justice Training Council sponsor the program, and all participation is strictly voluntary, we insist upon certain dress attire and hair grooming regulations. The Grooming Code calls for Boys to have a neat haircut with hair trimmed and tapered and for the girls - that the hair be neat and not so long as to create a safety hazard.