Form Lea-Cbw - Certification By Waiver Of Previous Training - Part Ii Application Paperwork Checklist
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1New Mexico Department of Public Safety Training Center
4491 Cerrillos Road, Santa Fe, New Mexico 87507
(505) 827-9251―(877) 237-7532 (NM Only) ―Fax: (505) 827-3449―
CERTIFICATION BY WAIVER OF PREVIOUS TRAINING – PART II
APPLICATION PAPERWORK CHECKLIST
The following documents must be submitted for enrollment in the New Mexico Department of Public
Safety Training Center’s Certification by Waiver of Previous Training Program, or New Mexico Regional
CBW Program.
Incomplete applications will be returned.
ITEMS REQUIRED
ITEMS REQUIRED BY ALL APPLICANTS
PPLICANTS
Form No. LEA-1 –
Application for Admission/Certification.
Form No. LEA-2 –
Employment Verification. Form must have original signatures.
Form No. LEA-3 –
Medical Examination Procedures, Medical History Statement and Medical Selection
Guidelines. Examination must be dated within one year prior to admission to applicable program. Must have
original signatures. (pages 1-17).
Form No. LEA-4 –
Current Psychological Examination. Form must have original signatures. Examination
must include psychologist’s narrative and be dated within one year prior to admission to applicable programs.
Form No. LEA-5 –
Fingerprint Affidavit. Form must have original signatures. . Submit only after FBI and
DPS clearances have been received.
Form No. LEA-6 –
Applicant Affidavit. Form must have original signatures.
Form No. LEA-8 –
Waiver of Liability. Form must have original signatures.
Form No. LEA-9 –
Release of Information. Form must have original signatures.
.
copy of high school diploma, G.E.D. certificate or college diploma
Notarized
Form No. LEA-12 –
Applicant Affidavit of United States Citizenship or proof of U.S. citizenship issued by
an official government agency. Hospital birth records and baptismal records are not acceptable. Photocopies
of birth certificates and Naturalization papers are not legal under New Mexico Law.
Form No. LEA-14 –
.
Physical Fitness Verification. Form must have original signatures
- Applicant Affidavit of proof of possession of a current valid driver’s license.
Form No. LEA-16
- Agency Employment Action. Form must have been previously submitted by employing
Form No. LEA-82
agency or attached to this application.
copy of DD214 form (if applicant has had military service) must have character of service.
Notarized
Mail Entire Packet to:
DPS USE ONLY
New Mexico Department of Public Safety
CBW Location:_______________________
Training Center, ATTN: Basic Training Bureau
CBW Dates___________________________
4491 Cerrillos Road, Santa Fe, NM 87507
DPS Use Only:
Part I Approved by Deputy Director:_______________________ Date: _______________
Basic Training Bureau Review by:__________________________ Date:________________
Regional CBW Academy Review by:_______________________ Date :_______________ (If Applicable)
Incomplete - Returned to agency/academy
Date returned:__________________
Part II Approved by Deputy Director:______________________ Date:_______________
Date Permanent file created:_____________________ File number_____________ (If Applicable)
Skills Manger profile created by____________________ Date___________________________
Out of State Certification entered into profile by:________________________ Date:__________ (If Applicable)
Profile creation pending. Reason:__________________________________________________
Revised 10-05-12
LEA-CBW (PART II)
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