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Name: ____________________ Student ID#:____________
Law Enforcement Program Application Packet
All application materials must be turned in at the same time to the Public Safety Main Office
All forms need to be turned in by the deadline indicated on your NWTC Student Program Checklist. **During the first semester of your Law Enforcement program, you will also be asked to complete the online DOJ
application, be fingerprinted at your own expense through a designated agency, and order a uniform. Information
on these steps will be delivered to you after the Fall semester begins and should not be started until then.
ITEM/FORM COMPLETED
CJ/LE Associate Degree Declaration (DJ-LE-329) DOJ Application (DJ-LE-327) – Please add your student ID to any additional pages
you add to the application.
NWTC LEAD Program Regulations –After reading through the document,
initial each page and fill out the last page. This is subject to change.
Original Birth Certificate/Certificate of Naturalization - Bring your
original Birth Certificate if born in the United States to the Public Safety Office. If born outside of the US, bring in your Certificate of Naturalization to show proof of citizenship as required by the Dept. of Justice. If you do not have an original, stamped birth certificate- you can go to Vitalchek.com and purchase an official, certified birth certificate- information included in this packet. The original certificate will be returned to you before you leave the Public Safety office.
Background Check- Completed online – go to CertifiedBackground.com and enter
package code: NF25- Background & Document Manager ($45). You will then be directed to set up your CertifiedProfile account and upload a completed BID form and complete the background check.
Medical Assessment (DJ-LE-332) - Applicant will need to have this signed by his/her
physician, physician asst., or nurse practitioner. This needs to be signed no more than 9 months prior to the first of the semester. It will need to be updated annually.
CJ Student Code of Conduct
Firearms Release of Information
LE Code of Ethics
CJ Release from Liability and Assumption of Risk Agreement
Student Authorization for Release of Information (DJ-LE-310)
Photo ID- It is a requirement that you have a NWTC Photo ID completed. This can be
done in the Student Involvement Office in SC118 on the Green Bay campus.
Fitness Test – Please note that you will be expected to pass a fitness test during the first
semester in order to start the second semester of core classes. More information can be found: https://www.nwtc.edu/Programs/Pathways/Law-Safety-and-Security/Program-Details/programs/Law-Enforcement-Academy-FAQs/Law-Enforcement-Physical-Readiness-Standard
If you have any questions regarding the Law Enforcement Program and/or application packet, please contact:
Kysa Walter
2740 W Mason St
Green Bay, WI 54307
Phone: 920-491-2627 Fax: 920-498-5673
E-mail: [email protected]
Wisconsin Department of Justice
Law Enforcement Standards Board
DJ-LE- 329, Rev. 10/12
www.wilenet.org
Student ID#:___________________
CRIMINAL JUSTICE / LAW ENFORCEMENT ASSOCIATE DEGREE CERTIFICATION TRACK STUDENT DECLARATION
The Wisconsin Law Enforcement Standards Board (LESB) is charged, in part, with the establishment of minimum eligibility standards for employment as a law enforcement or tribal law enforcement officer, and minimum educational and training standards for law enforcement and tribal law enforcement certification.
Since June 2, 1992, the LESB has approved the incorporation of basic law enforcement officer training competencies, learning objectives and performance standards from the basic law enforcement officer training academy into a Criminal Justice / Law Enforcement (CJ / LE) Associate Degree Program.
CJ / LE Associate Degree Certification Track Course Prerequisites
To be eligible to participate in a course that includes LESB-approved curriculum, CJ / LE Associate Degree Certification Track Students must meet the following prerequisites, and the training provider must maintain documentation showing that the prerequisites have been met:
• Be at least 17 years of age and enrolled as a Wisconsin Technical College System associate degree
student. Proof of age is required (form DJ-LE-322, Birth Certificate Verification form).
• Possess a general educational development diploma or be a high school graduate who has completed a secondary education program through a public school, private school, an equivalency diploma program, or home education program within the United States or its territories. Criteria for proof of compliance includes any of the following: a general educational development diploma; a high school diploma issued by a public school education program; a high school diploma issued by a private school; a high school equivalency diploma; or copies of form PI-1206 filed with the Department of Public Instruction for applicants who have completed a home school program in Wisconsin, or documentation that the education program has met the requirements of the Department of Education from the state where the home school program was completed.
• Complete the Application for Enrollment in Law Enforcement, Jail or Secure Juvenile Detention Officer Basic Training (form DJ-LE-327).
• Sign and file the Student Authorization for Release of Information (form DJ-LE-310).
• Sign and acknowledge compliance with the CJ / LE Associate Degree Program Rules, Penalties and Grievance Procedures.
• Sign and acknowledge compliance with the CJ / LE Associate Degree Program Grading Policy.
• Sign and date this Student Declaration form (form DJ-LE-329) declaring your intent to complete the CJ / LE Associate Degree Certification Track Program.
Tactical Course Enrollment Prerequisites To be eligible to enroll in courses containing the following tactical topics: Firearms, Defensive and Arrest Tactics, Emergency Vehicle Operations and Control, and Vehicle Contacts; CJ / LE Associate Degree Certification Track Students must meet the following additional prerequisites, and the training provider must maintain documentation showing that the prerequisites have been met:
• Complete an oral interview screening with criminal justice executives or with teaching or counseling staff
affiliated with the technical college.
Student ID#:___________________
• Undergo a criminal history records check, and not be prohibited by federal or state law from possessing a firearm.
• Possess a valid Wisconsin driver’s license or other valid operator’s permit recognized by the Wisconsin Department of Transportation as authorizing driving/operation of a motor vehicle.
• Complete a physical/medical assessment to verify that you can meet the physical standards required of a law enforcement officer (form DJ-LE-322, Physician’s Assessment form).
• Provide proof of United States Citizenship (form DJ-LE-322, Birth Certificate Verification form).
• Be administered, sign and file the Law Enforcement Code of Ethics as written in Wisconsin Administrative Code Section LES 3.01(1)(d), as an oath.
Academic and Behavioral Expectations
Certification Track Students must maintain personal integrity through truthfulness and ethical behavior. Contacts with law enforcement must be reported to faculty and/or the academy director within three (3) days of occurrence.
“Certifiability” Requirements
To be eligible for law enforcement officer certification (“certifiable status”), Certification Track Students must complete all CJ / LE Associate Degree Courses, including tactical courses, and the final scenario-based evaluation within three (3) years. The clock starts for a Certification Track Student on the first day the student enters into a CJ / LE Associate Degree Course (i.e. Introduction to Criminal Justice).
“Certifiable” Status
Certification Track Students who successfully complete basic training within the CJ / LE Associate Degree Certification Track Program are “certifiable” for three (3) years following their date of program completion. Students who do not gain Wisconsin law enforcement employment within three (3) years will lose their “certifiable” status.
I have read and understand the conditions and requirements for the CJ / LE Associate Degree
Certification Track Program, and I declare my intent to complete this Program. I have also read and understand the conditions and requirements for employment as a law enforcement officer set forth in Wisconsin Administrative Code Chapter LES 2, and included on pages 3 and 4 of this application.
I understand, to be eligible for “certifiable” status, I must complete all requirements within a three (3) year time frame, beginning with my first CJ / LE Associate Degree Course. My Certification Track
participation commenced on the 1st
day of the semester (listed below) and will terminate three (3) years from that date.
Student Signature Date
Student Name (Print) (Semester Start Date)
Student ID#:___________________
EMPLOYMENT STANDARDS
Recruitment qualifications are defined in Chapter LES 2, Administrative Rules of the Wisconsin Law Enforcement Standards Board. Applicants for employment as a law enforcement, tribal law enforcement, jail and/or secure juvenile detention officer must meet the following minimum requirements:
• Applicants must be 18 years of age or older.
• Applicants must possess a general educational development diploma or be a high school graduate who
has completed a secondary education program through a public school, private school, an equivalency diploma program, or home education program within the United States or its territories. Criteria for proof of compliance includes any of the following: a general educational development diploma; a high school diploma issued by a public school education program; a high school diploma issued by a private school; a high school equivalency diploma; or copies of form PI-1206 filed with the Department of Public Instruction for applicants who have completed a home school program in Wisconsin, or documentation that the education program has met the requirements of the Department of Education from the state where the home school program was completed.
• Applicants must possess a valid Wisconsin driver’s license or other such valid operator’s permit recognized by the Wisconsin Department of Transportation as authorizing operation of a motor vehicle in Wisconsin.
• Applicants shall not have been convicted of a felony or of any offense which if committed in Wisconsin
could be punished as a felony unless the applicant has been granted an absolute and unconditional pardon.
• Applicants for employment as a law enforcement or tribal law enforcement officer shall not have been
convicted of any misdemeanor crime of domestic violence unless the applicant has been granted an absolute and unconditional pardon.
The Omnibus Consolidated Appropriations Act of 1997 amended the Federal Gun Control Act, 18 U.S.C. §922(g)(9). Under these provisions, it is unlawful for an individual convicted of a state or federal “misdemeanor crime of domestic violence” to ship, transport, possess or receive firearms or ammunition. Law enforcement officers are not exempt from this law.
A “misdemeanor crime of violence,” pursuant to 18 U.S.C. §921(33)(a), means an offense that: has, as an element, the use or attempted use of physical force, or the threatened use of a deadly weapon, committed by a current or former spouse, parent, or guardian of the victim, by a person with whom the victim shares a child in common, by a person who is cohabitating with or has cohabitated with the victim as a spouse, parent or guardian, or by a person similarly situated to a spouse, parent, or guardian of the victim.
“Misdemeanor crimes of domestic violence” include all misdemeanors that involve the use or attempted use of physical force (i.e. simple assault, assault and battery) if the offense is committed by one of the defined parties. This is true whether or not the State statute or local ordinance specifically defines the offense as a domestic violence misdemeanor.
• Wisconsin State Statute §66.0501(1) states that no person may be appointed deputy sheriff of any county
or police officer of any city, village or town unless that person is a citizen of the United States. Wisconsin State Statute does not require United States citizenship for elected Sheriffs, Chiefs of Police, state law enforcement officers and deputy sheriffs who are not required to take an oath of office.
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Student ID#:___________________
Law enforcement or tribal law enforcement officers employed on or after February 1, 1993, shall possess either a two-year associate degree from a Wisconsin technical college system district or its accredited equivalent from another state or a minimum of 60 fully accredited associate degree level college credits or higher. The 60-college credit standard is defined in terms of semester credits. Quarter credits may be converted into semester credits by multiplying by two-thirds. Only colleges and universities that are accredited by an accrediting agency or association that is acknowledged by the United States Secretary of Education are acceptable to the Law Enforcement Standards Board as a source of college credit. School accreditation can be checked at http://www.ope.ed.gov/accreditation/. An applicant for law enforcement or tribal law enforcement employment who has not met this standard at the time of employment must meet the standard by the end of their fifth year of employment.
• Applicants shall be of good character as determined from a written report containing the results of the
following:
o The fingerprinting of the applicant with a search of local, state and national fingerprint records.
o A background investigation conducted by or on behalf of an employer.
o Other investigations as may be deemed necessary to provide a basis of judgment on the applicant’s loyalty to the United States or to detect conditions which adversely affect performance of one’s duty as a law enforcement, tribal law enforcement, jail or secure juvenile detention officer.
• Applicants shall be free from any physical, emotional or mental condition which might adversely affect
performance of duties as a law enforcement, tribal law enforcement, jail or secure juvenile detention officer.
• Applicants must undergo a physical assessment by a Wisconsin licensed physician to verify that the applicant
can meet the physical standards required of the position. The applicant must also provide the examiner with a personal medical history.
• Applicants must complete a satisfactory oral interview with the employing agency.
• Applicants shall submit to a drug test for the presence of the following controlled substances or their
metabolites: amphetamines, cannabis or cannabinoids, opiates, cocaine, and phencyclidine (PCP). The drug test analysis shall be conducted by a laboratory certified by the United States Substance Abuse and Mental Health Services Administration (SAMHSA).
NOTE: Under Wisconsin Statute §165.85(4)(e), any law enforcement or tribal law enforcement agency or sheriff may set recruit training and standards which are higher than the minimum standards set by the Law Enforcement Standards Board.
6
Wisconsin Department of Justice
Law Enforcement Standards Board
DJ-LE-327, 04/11
www.wilenet.org Student ID#_______________
APPLICATION FOR ENROLLMENT
BASIC LAW ENFORCEMENT, JAIL OR SECURE JUVENILE DETENTION OFFICER TRAINING NOTICE: All questions must be answered. Incomplete or illegible applications will not be considered. If the space provided is insufficient
for complete answers or you wish to furnish additional information, please attach additional pages.
1. PERSONAL INFORMATION
Name (Last, First, Middle)
Date of Birth (mm-dd-yyyy)
Social Security # (xxx-xx-xxxx)
Address (Apartment, Street, P.O. Box)
Home Telephone Number
City
State
Zip Code
Work Telephone Number
Email Address
Cell Phone Number
In the past, have you ever enrolled in a basic law enforcement, jail or secure juvenile detention officer training academy or courses?
Yes No
What type(s) of basic training did you enroll in? Law Enforcement Jail Secure Juvenile Detention Not applicable
If applicable, include the name and location (city and state) of the school(s) where you enrolled in basic training:
Are you a United States citizen? Yes No
Do you have a high school diploma, GED or HSED? Yes No
Do you have an Associate Degree or 60 associate degree level credits or higher from an accredited college or university? Yes No
If No, were you employed as a law enforcement officer prior to February 1, 1993? Yes No
The college credit requirement as written in Wisconsin Administrative Code § LES 2.01(1)(e), pertains to law enforcement and tribal law enforcement officers first employed on or after February 1, 1993.
Have you ever been convicted of a felony? Yes No
Have you ever been convicted of a misdemeanor crime of domestic violence? Yes No
Are you prohibited by state or federal law from possessing a firearm? Yes No
Do you possess a valid Wisconsin driver’s license or a valid driver’s license from another state? Yes No
2. EDUCATION
Dates
Name of School(s) From (mm/yyyy)
To (mm/yyyy) Degree, Diploma, or Credits Earned
High School(s)
College(s)
7
3. EMPLOYMENT Student ID#_______________
Begin with current or most recent employer. List chronologically all employment, including summer and part-time employment while attending school. To furnish additional employment information, attach sheets of the same size and format as this application.
Name and Address of Employer Dates of Employment
From (mm/yyyy) To (mm/yyyy)
Name of Employer:
Address:
Full-Time Part-Time
City:
State:
Zip Code:
Supervisor’s Name / Telephone Number:
May we contact the employer / supervisor?
Yes No
Position and kind of work:
Reason for Leaving:
Name and Address of Employer Dates of Employment
From (mm/yyyy) To (mm/yyyy)
Name of Employer:
Address:
Full-Time Part-Time
City:
State:
Zip Code:
Supervisor’s Name / Telephone Number:
May we contact the employer / supervisor?
Yes No
Position and kind of work:
Reason for Leaving:
Name and Address of Employer Dates of Employment
From (mm/yyyy) To (mm/yyyy)
Name of Employer:
Address:
Full-Time Part-Time
City
State:
Zip Code:
Supervisor’s Name / Telephone Number:
May we contact the employer / supervisor?
Yes No
Position and kind of work:
Reason for Leaving:
8
4. MILITARY SERVICE Student ID#_______________
Branch of Service
From (mm/yyyy)
To (mm/yyyy)
Active Duty or Reserve
Highest Grade Skill Specialty or Primary Duty
Honorably Discharged from Military Service? Yes No Not Applicable
5. REFERENCES
Give three references (not relatives, or present employer; avoid listing members of the clergy).
Name:
Position/Title/Profession:
Number of Years Acquainted:
Address:
City/State/Zip:
Telephone Number:
Name:
Position/Title/Profession:
Number of Years Acquainted:
Address:
City/State/Zip:
Telephone Number:
Name:
Position/Title/Profession:
Number of Years Acquainted:
Address:
City/State/Zip:
Telephone Number:
6. GENERAL
Attach no more than one additional page for each answer. A. Why have you chosen to enroll in basic law enforcement, jail and/or secure juvenile detention officer training?
B. Discuss things you have done which have contributed to your life experience. Be sure to include information regarding volunteer work with civic, school, or professional organizations. Be specific about names and dates.
C. Why do you believe you could relate to and/or work with people of different races, genders, cultures, ages, socio-economic groups, and educational levels?
Student ID#_______________
APPLICANT PLEASE READ CAREFULLY AND SIGN BELOW
Information provided and statements made as part of this application may be grounds for not allowing
you to enroll in basic training or for dismissing you after training has already begun. All information
and statements made are subject to verification.
CERTIFICATION
ALL INFORMATION PROVIDED AND STATEMENTS MADE BY ME AS PART OF THIS
APPLICATION, OR AS PART OF ANY ADDITIONAL INFORMATION PROVIDED IN SUPPORT OF
THIS APPLICATION, ARE COMPLETE, CORRECT, AND TRUE TO THE BEST OF MY
KNOWLEDGE.
I UNDERSTAND THAT IF I AM ALLOWED TO PARTICIPATE IN BASIC TRAINING, FALSE
INFORMATION PROVIDED OR FALSE STATEMENTS MADE AS PART OF THIS APPLICATION
MAY BE CONSIDERED AS CAUSE FOR DISMISSAL FROM TRAINING.
Applicants Signature
Date Signed
LAW ENFORCEMENT ASSOCIATE DEGREE (LEAD) PROGRAM REGULATIONS of NWTC and Wisconsin Department of Justice
Law Enforcement Standards Board - Training & Standards Bureau
The following regulations are based on the Certified Training School Operations Manual-State of Wisconsin, LESB and
will be complied with at all times. Certification by the Law Enforcement Standards Board is required prior to the granting
of a permanent appointment by the employing agency. Students failing to obey program regulations are subject to
dismissal, which, in turn, will result in not being certified.
Selection Process: NWTC will seek, screen and select Law Enforcement Associate Degree students who have displayed
and are demonstrating the behaviors that are consistent with the six core abilities identified by the LESB: the ability to
make decisions; use tactics; manage emergencies; conduct investigations; articulate and document actions; and interact
with others.
Applicants are required to provide information for a mandatory background investigation, physical fitness assessment
(demonstrating the applicant can safely participate in hands-on tactical training), personal interview, and academic
records. Further, students must bring the original birth certificate, or if born abroad, other documentation affirming their
U.S. citizenship. If at any time before, or during the Associate Degree Law Enforcement program, the student
demonstrates behaviors inconsistent with these requirements, or the capability of attaining the core abilities, the student
may be terminated from the program.
Attendance: Students are expected to attend all classes. This includes arriving on time and not leaving before being
dismissed. “Attending” means being here both physically and mentally, just as you will be required to do as a member of
the workforce. If you find that you will be absent from a class, it is your responsibility to notify the instructor prior to the
start of the class. Because skills in this course build upon one another, it will be necessary for you to contact another
student or the instructor to find out what you have missed prior to the start of the next class.
For purposes of certifiability, The Department of Justice (DOJ) will not allow students to miss more than 10% of the class
sessions for any reason. Tardiness and absences will be reported by the Dean of Public Safety and the Training and
Standards Bureau.
An excused absence is a failure to attend a class for medical care, family emergency, career testing or interview, military
service, or other circumstances as deemed appropriate by the involved faculty members. To be an excused absence, the
student must notify the involved faculty members of the absence as soon as the student is aware of the circumstance
prompting the absence. The absence will remain unexcused until the student completes the excused absence form,
completes the offsetting activities, and the faculty member has excused the student from the class.
Although excused absences are accepted for department testing and interviews, the excused time should be limited to only
that which is required for traveling to and from the event along with the actual time required to participate in the event.
Special attention to avoid any absence during the following course of instruction should be given:
Firearms
EVOC
DAAT
Professional Communication
Missing any part of these courses may result in the student having to make up the missed
portion of the class at the student’s expense.
Revised 10/15
Student ID#:___________ Initials______
Homework: Will be required by instructors and must be completed within the specified time. Students should anticipate
an average of two hours of outside preparation for each day of class. Assignments, given by instructors, which are not
completed and turned in on time, will be graded in accordance with the grading policy in the syllabus.
Students are expected to have basic computer skills. This is primarily for online learning activities and formative
assessments. This allows for the most efficient use of class time and will provide for increased hands-on and scenario
learning opportunities. Computer skills are also important for word processing and report preparation. Students with
insufficient computer skills are expected to participate in computer skills enhancement services or workshops offered on
campus or other student-initiated computer learning. Computer labs are available on campus during off-time hours.
Assessment: Students are evaluated through formative and summative assessments. In all matters relating to the Law
Enforcement Associate Degree program, students shall not copy an exam, plagiarize or cheat in any manner whatsoever.
If a student witnesses or has knowledge of dishonesty, the student shall report it to the instructor or Public Safety Dean.
Failure to report is as serious an offense as the dishonest act itself.
Formative Assessments: There are two types of formative assessments: Academic (Indirect assessments) and Hands-
on (Direct assessments). These assessments measure the student’s response to instruction throughout the semester.
Academic written assessments measure cognitive learning. Direct, hands-on assessments will also be administered. These
assessments are conducted using skill development exercises, isolation exercises and teaching scenarios specific to each
topic. These scenarios are conducted to determine the student’s ability to apply, synthesize, analyze and evaluate what
they have learned.
Academic assessments are developed from questions provided by the Wisconsin DOJ. The assessments are graded
according to the scale below:
Grading Scale
A 100 – 90%
B 89 – 80%
C 79 – 70%
F 69 or less
You will be completing exams in the classroom according to the schedule set forth in each respective academic syllabus
You may not take or refer to notes when taking an exam.
If you pass the exam on your initial attempt (70% unless otherwise outlined), that score will be the basis for your grade.
If you fail the initial attempt, you will be given a retest. o If you pass the retest, you will be assigned a score of 70% for the exam.
If you fail the initial exam, the retake must be proctored by the instructor, or his/her designee. It is your responsibility to make sure that your retest is arranged and proctored and that it is complete before the end of phase testing.
It is the student’s responsibility to review the material covered prior to any remediation or re-test.
A student who fails an initial test/PAT/Skills Checklist and the re-test for that topic will fail out of the Associate Degree Law Enforcement program per DOJ rule. These students will be required to retake all DOJ topics and meet all requirements even if they were passed at an earlier date.
All students will be required to complete a DOJ Phase test at the end of second, third and fourth semesters. Failure of the Phase exam for the semester will require a retest. Failure of the Phase retest will result in failure of the DOJ Law Enforcement class (all 10-504-700 level Law Enforcement courses). These students will be required to retake all DOJ topics and meet all requirements even if they were passed at an earlier date.
Spelling, grammar, and punctuation will be taken into consideration during the grading of short answer or essay questions on all tests and assignments.
Revised 10/15
Student ID#:___________ Initials______
Skills Checklists:
An individual who fails one or more skills on a skills competency checklist may be granted one re-test of
those skills. The retest must be done by a different instructor than the original test.
Prior to the re-test the student must complete remediation.
A student’s re-test of a skills competency checklist must include, at a minimum, the skills that the student
failed on the original skills checklist test.
A re-test of any student must be accomplished before the end of phase exam which is conducted at the end
of the second, third and fourth semesters.
Failure of a skills checklist re-test will result in failure of the DOJ Law Enforcement classes (all 10-504-700 level Law Enforcement courses). These students will be required to retake all DOJ topics and meet all requirements even if they were passed at an earlier date.
Instructors, on occasion, must provide remediation for hands-on evaluations. Instructors are not required to
document minimal remediation that results in an acceptable response from the student. Remediation that
involves additional instruction, learner research, or practice will require instructor documentation of the initial
observation, assistance provided, and any observable response to that assistance.
When a student needs to retake a topic due to failure and/or be remediated, it may be at the student’s expense.
Summative Assessment: is conducted during the final week of the semester/term. The DOJ Scenario Bank is
used in the Direct Assessment Testing Scenarios. Students who fail to meet the Scenario Requirements of the
DOJ will not pass the Scenario Assessment course, will not be certifiable and would be required to take all Law
Enforcement topics over in order to obtain certifiable status.
When determining the overall grade for a scenario, each of the objectives and section grades should be considered
as well as the extent to which safety of self and others was taken into consideration by the student. If the student
successfully meets the goal of the scenario without jeopardizing safety, a passing grade is warranted. If the goal of
the scenario was not met or safety was jeopardized to an extent that is unacceptable for a law enforcement officer,
a failing grade will be issued for the scenario.
Classroom Conduct: Instructors will ensure that appropriate conduct prevails throughout the course duration.
Students must be seated prior to the beginning of classroom instruction. Scheduled starting times must be met as
a courtesy to both the instructor and students. Loud or otherwise objectionable conduct will not be permitted.
Food will be allowed in the classroom at the discretion of the instructor. Electronic devices, newspapers,
magazines or other periodicals will be allowed in the classroom during instructional periods for class-related
purposes only. Such media sources present rich learning opportunities when used properly. Notebook computers
are an asset to students and NWTC classrooms provide wireless internet access. Computers may only be used to
supplement the specific course in session and with the permission of that instructor. Any violation of the NWTC
Information Systems Acceptable Use Policy may result in termination and/or criminal charges.
Weapons (lethal or non-lethal): All firearms and ammunition transported to the campus must be immediately
delivered to the Public Safety Building vault for inventory and storage. No firearms may be stored in personal or
government vehicles while those vehicles are parked on NWTC property. NWTC issued firearms (including red
guns, simulated firearms, ECD, and simulated ECD guns) will not be allowed off campus except when being used
at an authorized facility with an NWTC instructor.
Law Enforcement Associate Degree Uniform and Appearance: To ensure a neat, professional appearance, the
following attire will be worn: designated program uniform. Program uniforms are required to be worn during any
skill training and academic class. However, at the DAAT instructor’s discretion, students may wear their Physical
Fitness Training T-shirt, shorts and athletic shoes. Law Enforcement Associate Degree uniform items may not be
Revised 10/15
Student ID#:___________ Initials______
worn separately. Students will be well groomed, clean shaven, and present themselves suitably for employment at
all times (any exception to this rule requires prior written approval from the Dean of Public Safety).
Physician’s Assessment: Each student must possess a valid Physician’s Assessment (Form DJ-LE-332), clearly
indicating that the physician attests that the student is capable of performing the essential duties of a criminal
justice professional (law enforcement officer, correctional officer, or juvenile detention officer). A Physician’s
Assessment form is valid for the 370 contiguous days immediately following the date it was signed by the
physician. It is the student’s responsibility to secure a new Physician’s Assessment prior to the expiration of any
previously signed Physician’s Assessment. The student is responsible for producing the completed, valid
Physician’s Assessment form for any NWTC or DOJ staff member upon request. Failure to produce a valid, signed
Physician’s Assessment, clearly indicating that the student is fully capable of performing the essential duties of the
profession is grounds for immediate removal of the student from an activity, class, course, or program.
Safety: Activities will be designed with consideration for student safety. Unsafe activities by students or staff will
not be permitted. Safety is the most important factor in all training and will be the onsite responsibility of all
instructors and students at all times. At no time will a student’s personal weapons or vehicles be used in the
course of instruction. Violation of safety rules could result in termination.
Injuries: Student or staff injuries must be reported immediately, or as soon as possible to the program staff. The
NWTC Injury Report form must be completed and returned to the Dean of Public Safety and through the proper
procedure for the injured student’s department.
Parking: Parking is available throughout the campus. No permits are required. All signs and parking lot markings must
be obeyed. Fines and towing expenses are the student’s responsibility.
Use of Alcoholic Beverage: The Public Safety Department expects all students to have a .00 blood alcohol level at all
times during the training program. Students presenting evidence of having consumed intoxicants before or during class
will be subjected to alcohol testing (PBT). Violation of this rule will result in immediate notification to the student’s
department and dismissal from the class activity. Further sanctions, such as removal from the course or program may
also occur.
Professional relationships outside of classroom time, between students and instructors (full-time and adjunct), are
encouraged. Alcoholic beverages will not be consumed by either staff or student before or during such interaction.
Conduct in the building and on NWTC grounds: Students are responsible for keeping their areas clean. Students must
display professional conduct at all times. Fire procedures and regulations are posted in each room. Smoking is only
allowed in designated areas on campus.
Complaints: Student complaints must begin with the Public Safety Dean to ensure the NWTC internal protocol for
handling complaints will be followed. The Public Safety Dean may notify the Training and Standards Bureau of the
outcome of the complaint. An NWTC Incident Report may need to be generated at the discretion of the Public Safety
Deans.
Discipline: The Public Safety Dean handles all disciplinary matters. This program is designed to develop thoroughly
competent and confident criminal justice professionals; a part of this goal is instilling responsibility and respect for self
and others. Violation of these rules could include dismissal from the program. Appeal of any discipline will be directed to
the Public Safety Dean. Students are under the immediate responsibility of the respective instructors.
Revised 10/15
Student ID#:___________ Initials______
STARFISH - NWTC Cares about Your Success!
• Throughout the term, you may receive emails from Starfish®, a student success project between NWTC and Starfish Retention Solutions. These emails will be regarding your course grades or academic performance. Please pay attention to these emails and take the recommended actions. They are sent to help you be successful! • In the message you may be asked to contact your course instructor or a specific campus resource, such as academic coaching, academic advising or counseling. You may also be contacted directly by one of these services. • You may also receive messages (known as “Kudos”) from your instructor, recognizing academic achievements. • You can access Starfish via the tab found on your Blackboard page. Student Code of Conduct: In order to maintain high standards of instruction and to permit all who attend NWTC to obtain the most from their educational experience, students will: a) conduct themselves in a manner as to comply with all civil and criminal laws and college policies and regulations while on NWTC properties or off-site school sponsored events; b) not interfere with the educational process of the College in any manner; c) conduct themselves both on-campus and off-site so that they do not endanger the safety or well-being of other students, staff or faculty. Students who fail to observe general standards of acceptable conduct or who disrupt the educational process may be suspended, dismissed, and/or subject to legal action for offenses including, but not limited to the following:
1. Physical or verbal abuse, threats, intimidation, harassment or detention of any person on NWTC property or at
NWTC sponsored activities, which may endanger his/her health, safety, or civil rights.
2. Public use of inappropriate language, which interferes in any way with the educational experience of other
students.
3. NWTC has zero tolerance for bomb threats. Any such action will result in immediate dismissal.
4. Interference with the learning process of other students or failure to follow behavioral and safety rules identified
for the learning environment, including classrooms, labs, clinics, or other college designated areas.
5. Theft or damage to NWTC property, including abuse of computer time and/or equipment.
6. Theft of any funds, including forging documents for financial gain.
7. Possession of firearms, dangerous articles, incendiary devices, explosives, or other potential weapons are
forbidden on NWTC owned or operated property or at NWTC sponsored activities, except in program and/or
course required and designated instances.
8. Violation of NWTC’s Alcohol and Drug Policy for Students as published in the ―Student’s Right to Know
section of the Student Handbook.
9. Violation of the College’s Technology Use Policy, or any NWTC policy.
10. Use of camera phones or any photographs is prohibited when others would have a reasonable expectation of
privacy.
11. Dishonesty, including cheating and plagiarism, or knowingly furnishing false information to NWTC.
12. Violation of federal, state, or local laws while on NWTC premises, at NWTC-sponsored activities, or in any
context which might endanger the safety or well-being of other students, staff or faculty, or which might
otherwise be detrimental to the interests of the College.
13. Any other behavior considered harmful to students, the college community, or the teaching/learning process.
14. Use of technology not conducive to learning, (i.e. online gaming).
15. Any audio recordings made of conversations of participants in program classes, or instructors will be done with
the knowledge of all participants. All recordings shall also be done in complete view of those involved.
Revised 10/15
Student ID#:___________ Initials______
NORTHEAST WISCONSIN TECHNICAL COLLEGE LAW ENFORCEMENT ASSOCIATE DEGREE (LEAD) PROGRAM
and Wisconsin Department of Justice
Law Enforcement Standards Board - Training & Standards Bureau
Agreement of Conduct
I, _________________________________________ have read and understand the above listed policies and
rules. I have also received a copy of this document.
Signature________________________________________ Date________________
Student ID#:___________
Revised 10/15
Wisconsin Department of Justice
Law Enforcement Standards Board
DJ-LE-332 (8/15)
MEDICAL ASSESSMENT (LAW ENFORCEMENT, JAIL, OR JUVENILE DETENTION OFFICER AND/OR PREPARATORY TRAINING STUDENT)
1. Applicant’s Name: _________________________________________________________________________________
Last First MI
2. Sex: Male Female
3. Position or Training Applied for: Law Enforcement Jail Juvenile Detention
4. Hiring Agency or Training School: ___________________________________________________________________
5. Examining Physician/Physician’s Assistant/Nurse Practitioner-PLEASE READ CAREFULLY BEFORE EXAM:
Wisconsin law requires all applicants for Law Enforcement, Jail and/or Juvenile Detention Officer Employment be free from any physical, emotional,
or mental condition which might adversely affect performance of duties as an officer. The law further requires all applicants attend and successfully
complete a preparatory training program approved by the Law Enforcement Standards Board (LESB). The hiring standards and training programs
approved by the LESB are based upon a validated analysis of the tasks officers perform or must be prepared to perform each day. These tasks include
the following: walking for extended periods (4 hrs or more), short sprints (350’), running up and down stairs (4 flights or more), pushing heavy objects
(170 lbs), jumping over and around obstacles, lifting 100 lbs or more and carrying heavy objects (50 lbs or more), using hands and feet in use of force
situations, as well as bending and reaching. Additionally, applicants should have normal depth and color perception and be free of any other significant
vision or hearing abnormalities.
To prepare recruits to meet these challenges, while at the training academy they will practice handcuffing, baton, and weapon retention techniques;
run, jump, and be thrown to the ground; and participate in role-play of job-related scenarios which requires strength, agility, and endurance.
Additionally, law enforcement recruits will drive emergency vehicles; qualify with a handgun and a rifle; and are expected to pass a physical fitness
exam prior to the start of the academy and at the end of academy. The physical fitness exam for law enforcement recruits consists of:
Event Entrance Standard (prior to Academy) Exit Standard
1.5 Mile Run 20:20 or less 16:57 or less
300 Meter Run 82 sec or less 68 sec or less
Push-Ups min 18 min 23
Sit-Ups min 24 min 30
Vertical Jump min 11.5 in min 14 in
Agility Run 23.4 sec or less 19.5 sec or less
Disabilities, impairment, or limitations identified by the examination, which could prevent an applicant from performing the essential
functions of the job or training mentioned above should be documented and reported to the employing agency or training school.
I hereby attest that I have examined the above named applicant and find him or her capable of performing the essential
functions of the position and/or safely participating in preparatory training.
I hereby attest that I have examined the above named applicant and find him or her not capable of performing the essential
functions of the position and/or safely participating in preparatory training.
6. ________________________________________________________ 7. ____________________________
Licensed Physician, Physician Assistant, or Nurse Practitioner’s Signature Examination Date
8. _________________________________________________________________________________________________
Licensed Physician, Physician Assistant, or Nurse Practitioner’s License Number and Phone Number
By signing below the applicant acknowledges that this form is valid for 12 months from the date of the exam noted in item 7 for entrance into preparatory
training, as well as his/her responsibility to notify the hiring agency or the training school of any changes in his/her medical condition during that time.
9. _________________________________________________________________ 10. _________________________________
Applicant’s Signature Date
Student ID#: ___________
INSTRUCTIONS FOR COMPLETING THE MEDICAL ASSESSMENT FORM (DJ-LE-332)
EMPLOYERS:
Employers shall attach the JOB DESCRIPTION of the position applied for to the Medical Assessment form for the licensed Physician,
Physician Assistant, or Nurse Practitioner to review and assist them in determining whether the applicant is able to perform the essential
job functions of the position. The completed Medical Assessment form shall be maintained by the hiring agency. The medical
assessment must be conducted no more than nine (9) months prior to the first date of employment.
TRAINING SCHOOLS:
Training schools shall ensure the medical assessment is completed prior to the start of the academy. The completed Medical Assessment
form may be maintained by the training school in the student’s records and will be submitted to Training and Standards as per the
guidelines in the Director’s Manual.
COMPLETION OF THE MEDICAL ASSESSMENT FORM BY THE EMPLOYING AGENCY OR TRAINING SCHOOL
(SECTIONS 1 – 4)
1. Applicant’s Name: Enter the applicant’s full legal name.
2. Sex: Mark the appropriate box for the sex of the applicant.
3. Position or Training Applied for: Check the box for one of the following disciplines: Law Enforcement, Jail, or Juvenile
Detention Officer.
4. Hiring Agency or Training School: Enter the hiring agency’s name or the name of the training school.
COMPLETION OF THE MEDICAL ASSESSMENT FORM BY THE PHYSICIAN, PHYSICIAN ASSISTANT, OR NURSE
PRACTITIONER (SECTIONS 5 – 8)
5. Physician, Physician Assistant or Nurse Practitioner’s Assessment: In your opinion is there any medical or physiological reason
that may impair the applicant’s ability to perform the essential functions of the position for which he or she has applied, or the
preparatory training involved? Please check the box indicating whether the applicant is capable or not capable of performing the
essential functions of the position and participating in preparatory training.
6. Physician, Physician Assistant, or Nurse Practitioner’s Signature: Signature of the physician, physician assistant, or nurse
practitioner.
7. Examination Date: Enter the date on which the examination was completed.
8. Physician, Physician Assistant, or Nurse Practitioner’s License Number and Phone Number: Enter the license number of the
physician, physician assistant, or nurse practitioner and the professional phone number.
COMPLETION OF THE MEDICAL ASSESSMENT FORM BY THE APPLICANT (SECTIONS 9 – 10)
9. Applicant’s Signature: The applicant signs the completed form after the medical exam acknowledging the results of the
assessment and the forms validity for 12 months from the date of the exam noted in item 7 for entrance into preparatory training,
and his/her responsibility to notify the hiring agency and/or the training school of any changes in his/her medical condition during
that time.
10. Signature Date: Enter the date on which the medical assessment form was signed by the applicant; should be the same as, but no
earlier than the date in section 7 of the medical assessment form.
Student ID#: ___________
Student ID# ______________
Criminal Justice Student Code of Conduct
Please initial each of the following criteria.
_____ 1. I have not had any police contact for criminal matters and/or traffic violations since
applying to the Criminal Justice Program. If there has been police contact or traffic violations, I have
notified the Public Safety Dean in writing as well as provided written documentation to the Public
Safety Office for my student file.
_____ 2. I currently possess and maintain a valid driver’s license. (State) _____
I ____________________________ voluntarily accept the affirmative duty to immediately
notify the Public Safety Dean in writing of any changes in the criteria described above. I further
accept this duty with full knowledge that I may be expulsed immediately from this class, course
and/or the Criminal Justice program; therefore, my privilege to participate in any or all of these or
future NWTC classes, courses, or programs may be discontinued.
Please print:
Full Name: ___________________________________________________
Signature: ____________________________________________________
Date: _______________
Student ID: _______________ Firearms Release of Information
This form is intended to certify legal residence and/or operator legality of a firearm for use/possession in the
Law Enforcement Associate Degree &/or Law Enforcement Academy.
Legal Name (Last, First, MI)
Sex: Race: Date and Place of Birth
Other Name(s) used now or at any time in the past (e.g. maiden/alias) SS#:
Residence Address: City: State Zip Code
Answer each question with a “YES” or “NO” in each box at the right of the question. YES OR NO
1. Have you ever been convicted of a felony in this state or a crime
elsewhere that would be a felony if committed in Wisconsin? (A
felony is any crime for which you could have been imprisoned for
more than one year even if you were not imprisoned or served less
than one year).
2. Have you ever been found or adjudicated not guilty of a felony in
Wisconsin or any other jurisdiction by reason of insanity, mental
disease, defect, or illness?
3. Have you ever been adjudicated delinquent as a juvenile for an act
committed on or after April 21, 1994, that if committed by an adult
in Wisconsin would be a felony and have not been exempted from
the firearm prohibition by order of a court pursuant to S941.29 (8)?
4. Are you subject to a court order under the Wisconsin Mental
Health Act (CH. 51) prohibiting you from possessing a handgun?
5. Are you subject to a court order under the harassment injunction
law (sec. 813.125) prohibiting you from possessing a firearm?
6. Are you subject to a domestic abuse injunction or domestic abuse
tribal injunction (sec 813.12) or a child abuse injunction (sec.
813.122)?
7. Are you under indictment or information in any court for a felony,
or any other crime, for which the judge would imprison you for
more than one year? (An information is a formal accusation of a crime by a prosecutor.
See Definition 3)
8. Are you a fugitive from justice?
9. Are you an unlawful user of, or addicted to, marijuana, or any
depressant, stimulant, or narcotic drug, or any other controlled
substance?
10. Have you ever been adjudicated mentally defective (which includes
having been adjudicated incompetent to manage your own affairs)
or have you ever been committed to a mental institution?
11. Have you been discharged from the Armed Forces under
dishonorable conditions?
12. Have you been convicted in any court of a misdemeanor crime of
domestic violence?
13. Have you every renounced your United State citizenship?
14. Are you and alien illegally in the United States?
15. Are you a United States citizen?
Page 1 of 2
Student ID: _______________
I certify that all statements on Firearms Release of Information are true. I understand that if I knowingly
make a false statement, I may be subject to penalties, fines, and/or imprisonment under WI Statues and/or
Federal Law. WARNING: TRANSFER TO MINORS, FELONS, AND PROHIBITED PERSONS. It is illegal
for anyone to provide or assist with providing a firearm to a minor, except under certain conditions as set forth
in the Wisconsin Statues, and under any circumstances to provide or assist in providing any firearm to a
convicted felon or any other person prohibited by law from possessing a firearm under S941.129.
Signature:___________________________________________________
Date __________________________________
DEFINITIONS Under indictment or information or convicted in any court: An indictment, information, or conviction in any Federal, State, local or foreign court.
Misdemeanor Crime of Domestic Violence: A Federal, State, or local offense that is a misdemeanor under Federal or State law and has as an element the use or
attempted use of physical force, or threatened use of a deadly weapon, committed by a current or former spouse, parent, or guardian of the victim by a person with
whom the victim shares a child in common, by a person who is cohabitating with, or has cohabitated with the victim as a spouse, parent, or guardian, or by a person
similarly situated to a spouse, parent, guardian of the victim. The term includes all misdemeanors that have as an element the use or attempt use of physical force or the
threatened use of a deadly weapon (e.g. assault and battery), if the offense is committed by one of the defined parties.
State of Residence: The State in which an individual resides. An individual resides in a State if he or she is present in a State with the intention of making a home in
that State. If an individual is a member of the Armed Forces on active duty, his or her state of residence is the State in which his or her permanent duty station is
located. An alien who is legally in the United States is a resident of a State only if the alien is residing in the State and has resided in the State for at least 90 days prior
to the date of sale or delivery of a firearm. These samples illustrate this definition:
Example 1: A maintains a home in State X. A travels to State Y on a hunting trip. A does not become a resident of State Y by reason of such trip.
Example 2: A is a U.S. citizen and maintains a home in State X and a home in State Y. A resides in State X on weekdays, and in State Y on weekends.
During the time A actually resides in State X, A is a resident of State X. During the time A actually resides in State Y, A is a resident of State Y.
PRIVACY ACT INFORMATION
Disclosure of the individual’s social security number is voluntary. The number may be use to verify the
individual’s identity.
Page 2 of 2
Student ID: _______________
Law Enforcement Code of Ethics Wis. Admin. Code Sec. LES 3.01(1)(d)
AS A LAW ENFORCEMENT OFFICER, my fundamental duty is to serve
humanity; to safeguard lives and property; to protect the innocent against deception,
the weak against oppression or intimidation, and the peaceful against violence or
disorder; and to respect the Constitutional rights of all persons to liberty, equality and
justice.
I WILL keep my private life unsullied as an example to all; maintain courageous
calm in the face of danger, scorn, or ridicule; develop self-restraint; and be constantly
mindful of the welfare of others. Honest in thought and deed in both my personal and
official life, I will be exemplary in obeying the laws of the land and the regulations of
my department. Whatever I see or hear of a confidential nature or that is confided to
me in my official capacity will be kept ever secret unless revelation is necessary in the
performance of my duty.
I WILL never act officiously or permit personal feelings, prejudices, animosities,
or friendships to influence my decisions. With no compromise for crime and with
relentless prosecution of criminals, I will enforce the law courteously and appropriately
without fear or favor, malice or ill will, never employing unnecessary force or violence
and never accepting gratuities.
I RECOGNIZE the badge of my office as a symbol of public faith, and I accept it
as a public trust to be held so long as I am true to the ethics of the police service. I will
constantly strive to achieve these objectives and ideals, dedicating myself to my chosen
profession….law enforcement.
Name (print)__________________________________________
Signature __________________________________________ Date_____________
Student ID#: _________________
Criminal Justice Program
Release from Liability and Assumption of Risk Agreement
Intending that this agreement be legally binding on me, my heirs, executors, administrators, and
assigns, I hereby waive, release and forever discharge Northeast Wisconsin Technical College and its
agents, representatives, heirs, executors, administrators, successors and assigns from any and all
claims, demands, rights and causes of action of whatsoever kind and nature, arising from and by
reason of any and all known and unknown, foreseen and unforeseen physical and mental injuries and
consequences thereof, suffered by me during any and all training activities held at Northeast
Wisconsin Technical College during the course of my enrollment.
Name (print clearly) ______________________________________
Signature ______________________________________
Date ______________________________________
1
Wisconsin Department of Justice
Law Enforcement Standards Board
DJ-LE-310, Rev. 03/10
www.wilenet.org
STUDENT AUTHORIZATION FOR RELEASE OF INFORMATION (For official use only, not to be released to unauthorized persons)
I, (Student Name)
, authorize
Northeast Wisconsin Technical College
(Training School) , (referred to
hereafter as “the Training School”) to release to the Wisconsin Department of Justice, Training and
Standards Bureau and/or its employees (collectively referred to hereafter as “the Bureau”) any
and all academic records or information in the possession of the Training School related to
my attendance, performance, achievement and all other aspects of my participation in any training
courses and/or programs including, but not limited to, the academic records listed on the reverse
side of this form, for the purpose of validating that the Training School and its students meet
eligibility and certification standards established by the State of Wisconsin Law Enforcement
Standards Board. I understand that this authorization will remain in effect until I rescind it by
submitting a letter to the director of the Training School’s preparatory law enforcement, jail and/or
secure detention program specifying that I no longer wish to authorize access to my academic
records or information.
I also authorize the Bureau to disclose any or all of the information described in the preceding
paragraph to any training school certified by the Law Enforcement Standards Board. Furthermore,
in the event that I am employed by or have applied for employment with one or more law
enforcement, jail and/or secure juvenile detention employers, I authorize the Bureau to disclose
any or all of the information described in the preceding paragraph to such employers. I understand
that this authorization will remain in effect until I rescind it by submitting a letter to the director
of the Bureau specifying that I no longer wish to authorize such disclosure.
Date Signature - Full Name
Student ID#:______________
2
MINIMUM ACADEMIC RECORDS MAINTAINED ON
ALL STUDENTS IN PREPARATORY LAW ENFORCEMENT, JAIL AND SECURE
JUVENILE DETENTION OFFICER TRAINING PROGRAMS
• Student rosters including enrolled student names and social security numbers.
• Attendance records.
• Student withdrawal/termination from training.
• Any incomplete or failed program.
• Documentation of any disciplinary or other problems and sanctions imposed.
• Staff evaluations of student performance.
• Exams and examination results.
• Performance assessment tasks and performance assessment task results.
• Completed skills competency checklists for specific skills subjects.
• Board-approved student transcripts (DJ-LE-300, DJ-LE-301, DJ-LE-302, DJ-LE-307A, DJ-LE-307B,
DJ-LE-308, DJ-LE-309 and DJ-LE-302A through DJ-LE-302J).
• Signed copy of the Law Enforcement Code of Ethics.
• Signed form attesting that the school’s written rules, penalties and grievance procedures have been
distributed, read and understood.
• Signed form attesting that the school’s grading policy has been distributed, read and understood.
• Copy of valid photo driver’s license (law enforcement students).
• Copy of the Verification of Employment Standards and Application for Certification form
(DJ-LE-303), obtained from the employing agency (employed students).
• Completed copy of the Application for Employment as Law Enforcement or Jail Officer
form (DJ-LE-330) (pre-service and college certification track students).
• Record of oral interview (pre-service and college certification track students). • Results of criminal history records check (pre-service and college certification track students).
• Completed Physician’s Assessment form (DJ-LE-332), or a form similar to DJ-LE-332, providing
authorization by a licensed physician, physician assistant or nurse practitioner for student participation in
training.
• Copy of high school diploma or high school transcript showing attainment of a high school
diploma; or copy of high school equivalency diploma (HSED) or copy of certificate of general
educational development (GED). (Pre-service and college certification track students)
• Official college transcript showing attainment of at least 60 fully-accredited college credits (pre-
service law enforcement students).
• Completed copy of the Birth Certificate Verification form (DJ-LE-322), or a certified copy of the
student’s birth certificate (pre-service and college certification track students).
Student ID#:______________
