Protect the Protectors Scholarship Application 2020-21

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Please use this form to request a scholarship for the Protect the Protectors program in 2020-21. The number of scholarship available to any one department will depend on the total number of requests received and the total funds available. There will be a *minimum* of 25 total scholarships available for Miami, Darke and Shelby Counties. Please register each person separately.

First name *

Last name *

Rank/Title *

Officer

Deputy

Sergeant

Lieutenant

Captain

Chief

Sheriff

Other:

Employer *

Miami County Sheriff's Office

Darke County Sheriff's Office

Shelby County Sheriff's Office

Sidney Police Department

Greenville Police Department

Troy Police Department

Piqua Police Department

Tipp City Police Department

West Milton Police Department

Piqua Post OSHP

Other:

Years in Law Enforcement *

Are you a CIT Officer? *

Yes

Email *

Please provide an email address where we can send you information about the training

Phone number *

Please provide a phone number where you can be reached with late-breaking updates

Comments

Please add any additional comments

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