Form Center

Explorer Application email

2. 

3. Groveland Police Department
   408 W. Orange St. Groveland, FL 34736
   Ph: 352-429-4166
   Fx: 352-429-5559
   Emergency: 911

5. To: Sergeant Alica Menendez

7. First Name

8. Last Name

9. Phone Number

11. Address

13. City

14. State

15. Zip Code

17. Reply email addess*

    Enter the email you want your reply sent to

19. Age*

    1. A) 14
    2. B) 15
    3. C) 16
    4. D )17

    1. E) 18
    2. F) 19
    3. G) 20

    Please select your current age

21. Gender

23. Parent Contact

25. First Name

26. Last Name

27. Phone Number

29. Comments / Questions "Why are you interested in the post?"

31. How did you hear about the post?

Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field