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Forms & Applications
Forms and Applications
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Law Enforcement Agencies and Academies
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.
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MCOLES Information and Tracking Network (MITN) Forms
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.
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.
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In-Service Training Forms
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.
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.
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LEOSA Forms
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.
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RPTE Forms
Recognition of Prior Training and Experience Application Packet
This application should be used to apply to the Recognition of Prior Training and Experience (RPTE) program.
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PSOB Forms
PSOB Death Benefit Application
This application should be completed to apply for the PSOB death benefit.
This application should be completed to apply for the PSOB disability benefit.