Please read the following before proceeding:

Applicant Information:

Expiration Date Information:

Previous Aliases: (please list all previous aliases)
Previous Last Name Previous First Name Previous Middle Name

Information Related To Your Birth:

Demographic Information:

feet inches

Telephone Number: (###-###-####)

Qualification Date:


Please Create A Password: (you can use this to track progress, and we may need to contact you during the process)

Password Information: In order to comply with CJIS standards we have employed the use of a password complexity monitor. As you enter your password, we will display an indicator of complexity. You will only be able to submit passwords that are sufficiently complex as to be considered 'safe' by CJIS standards. The visual indicator will turn Blue or Green to indicate that your password is safe.

Important: CJIS requires we maintain a strict password policy and system of checks. As such, we check the following items as you enter your new password:
  • The password must be a minimum length of eight (8) characters on all systems
  • The password must not be a dictionary word
  • The password must not be the same as your email address
  • The password must not be a proper name

Current Residence Address: (this may be different than your mailing address)

Present Mailing Address: (if different from residence address)

Attach Documentation: please upload the required documentation.

To upload documentation, please use the button below to begin the process. Please scan each document individually. The maximum size of individual files is 5 MB.        
  • The LEOSA form completed by a qualified instructor - (REQUIRED for NEW and RENEWAL)
  • A photocopy of your photographic law enforcement identification credentials. (REQUIRED for NEW)
  • A letter from the agency with which you were employed that verified your employment status and that you meet the requirements of a qualified retired law enforcement officer listed below. (REQUIRED for NEW)
    • The letter must:
      • Be on the agency’s letterhead.
      • Include your name, employee badge number, rank, and dates of employment.
      • Attest that the applicant meets the requirement of a qualified retired law enforcement officer.
      • Attest that the applicant has been issued a photographic law enforcement identification card.
      • Include the name, title, identification number, and contact phone number of an individual at the agencywho can verify employment information.

Uploaded Files:

Add files...
Please select a document type then, click on the “Attach” button to complete the upload process.

Select Purchase Option:

Total Fee:
Survey Questions:


Agency Name:

City & State:

Date of Employment

Start Date:

Separation/Retirement Date:

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You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below
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  • Your Appointment Choice Is:

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I attest under penalty of perjury that all statements made on this application are true.

I further attest that I have reviewed and am knowledgeable of Arizona Revised Statutes, Title 13, Chapters 4 and 31.

By signing the application, you are agreeing to the Privacy Act. Please CLICK HERE to view.

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