Forms & Applications

Candidates Personal History Statement and Affidavit

The Candidates Personal History Statement and Affidavit (PHSA) should be used for all applicants (Employed Recruits, Academy Applicants, Licensing Applicants) who wish to apply for academy admission, license activation or license reactivation (including officers with active licenses moving to another agency).

The PHSA must be downloaded and completed on a computer. Handwritten PHSA will no longer be accepted.

Addendum to Candidates Personal History Statement and Affidavit

The Addendum supports the PHSA application to enter into the training or licensing process. 

Waiver and Authorization for Release of Information

The waiver and authorization should be the first document an applicant completes when applying for a position with your agency or academy. The waiver and authorization for release of information form allows you as the agency or academy permission to look the individual up in the MCOLES Information and Tracking Network (MITN) for screening and background purposes. If the individual has worked for and separated from an agency on or after January 15, 2018, your agency must send a copy of the completed form to those agencies to receive the reasons for and circumstances surrounding the separation.

Pre-Enrollment Physical Fitness Exam Physician's Health Screening Form

This form should be completed prior to the Pre-Enrollment Physical Fitness Exam. This form must be completed by a Physician, Physician Assistant or Nurse Practitioner. This form will attest that the examinee is physically capable of performing the 4 exercises listed that are required to be performed during the MCOLES Physical Fitness Test.

Law Enforcement Officer Applicant Drug Test Report Form

This form is to be used ONLY for reporting those applicants who have tested positive or failed to provide a urine specimen as instructed. 

LED Expenditure Report Addendum

This spreadsheet should be completed if your agency requires changes to prior years Law Enforcement Distribution (LED) expenditures you reported during Annual Registration.

NOTE: All signed, completed agency agreements and addendums should be scanned and EMAILED to the Licensing Services Section at msp-mcoles-licensing@michigan.gov or FAXED to 517-636-7886.

MCOLES Information and Tracking Network (MITN) User Agency Agreement

This Agreement serves as an application for Law Enforcement Agencies, Basic Law Enforcement Training Academy and In-Service Training Providers to gain access to the MCOLES Information and Tracking Network (MITN).

MCOLES Information and Tracking Network (MITN) Operator Agreement

This application should be completed and signed by the entity head to add individuals as a MITN operators for your agency.

MCOLES Information and Tracking Network (MITN) Law Enforcement Agency User Agreement Addendum

This document will serve as an Addendum to the original User Agency Agreement previously entered into between MCOLES and the Law Enforcement Agency.

MCOLES Information and Tracking Network (MITN) Criminal Justice Training Agency User Agreement Addendum

This document will serve as an Addendum to the original User Agency Agreement previously entered into between MCOLES and the Criminal Justice Training Agency.

MCOLES Information and Tracking Network (MITN) Basic Training Academy User Agreement Addendum

This document will serve as an Addendum to the original User Agency Agreement previously entered into between MCOLES and the Basic Training Academy.

Out-of-State Special Use Request 

This application should be used if your agency would like to send officers out-of-state for training and you wish to use Law Enforcement Distribution (LED) funds. This application must be completed prior to the training.

Equipment Special Use Request

This application should be used if your agency would like use Law Enforcement Distribution (LED) funds to purchase equipment that exceeds $5,000 or 10% of your agency's annual distribution. This application must be completed prior to purchasing the equipment.

Application For Law Enforcement Officers Safety Act (LEOSA) Certification

This application should be completed for Law Enforcement Officers Safety Act (LEOSA) certification and certification renewal.

I. APPLICATION FEE (link to PDF)

Instructions....

II. EMPLOYMENT LETTER (link to PDF)

Instructions... 

III. LIVESCAN FINGERPRINT BACKGROUND CHECK REQUEST

Instructions....

IV. PERSONAL HISTORY STATEMENT AND AFFIDAVIT

Instructions... 

V. VERIFICATION OF BASIC TRAINING AND LICENSURE

Instructions....

VI. WAIVER AND RELEASE OF AUTHORIZATION

Instructions...

PSOB Death Benefit Application

This application should be completed to apply for the PSOB death benefit.

PSOB Disability Application

This application should be completed to apply for the PSOB disability benefit.