Author: Morgan Sears

El Dorado County Sheriff’s Office
Explorer Information Record

Name:
Last First Middle
Mailing Address:
City:
Physical Address:
City:

Confidential Information for Explorer Advisors Only

Time in Post: Rank:
Drivers License #:
Email:
Cell Phone:

School Name: Grade:
School Address:

Employer: No Employer
Employer Address:

Emergency Information:

Name: Relationship:
Address:
Phone Number: Secondary Number:
Alternate Contact Name: Relationship:
Address:
Phone Number: Secondary Number:

Signature (of Explorer over 18 or Parent)	Date

It is the responsibility of the explorer to submit an updated form to an advisor should any of the above information change

CONFIDENTIAL