Please fill out the form below reading each section very carefully.
(if different from above)
ORS; OAR Standards - Admission to the Police Reserve Academy is subject to the minimum standards, policies and objectives established in ORS 181.630; OAR 259-008-0000. Factors 1 – 4 will be assessed by the PRA instructional staff:
Student Success Standards -
Agency Sponsorship/Recommendation - Applicants who meet both ORS and OAR along with the PRA Program standards as outlined above in the above sections selection for admission into the Police Reserve Academy according to the following:
I hereby authorize Umpqua Community College, its District, Board of Directors and its employees (UCC), or persons hired by UCC to photograph, record, tape, film, or electronically capture my name, likeness, image, voice, biographical and personal information, appearance and/or performance, and/or further to use and publish my writing(s) (collective work). I further grant UCC full permission to edit my writings and the original footage, data, voice or image as shall be deemed necessary; that the work and my name may be used, published and distributed without remuneration to me, for educational, instructional or promotional purposes in print or over open broadcast, cable, audio-visual, radio, closed-circuit exhibition, computer, or other medium for college purposes as deemed appropriate by UCC.
For these purposes, I waive and relinquish my personal rights, privacy rights and rights under the Family Education Rights, Privacy Act (FERPA) and student records law of the state of Oregon. I hereby waive all rights to any claim for royalties or other payments. Said work and all components thereof shall become the property of UCC and may be copyrighted in its own name or a name of its choosing.
I have read the above information with an understanding of the conditions for acceptance into the Police Reserve Academy Program. Further, I authorize (by my digital signature below) Umpqua Community College, their staff or designee to record my information for College purposes and conduct a criminal background check to determine my fitness into the Umpqua Community College Police Reserve Academy Program.
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