Physical Fitness Test Registration Form

Mott Community College Law Enforcement Regional Training Academy - LERTA

I have reviewed the MCOLES Employment Standards for Michigan Law Enforcement Officers - Testing and would like to register for the a Physical Fitness Test date at Mott Community College.

Name

First

Middle

Last

Date of Birth

Month ~ JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Day ~ 12345678910111213141516171819202122232425262728293031

Year ~ 20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926

Address

Street

City

State

Zip

Contact

Phone

Cell

Email

A copy of this reservation will be sent to the above email address.

Driver's License Number

Test Date -- Choose a Date -- Sunday, 08/09/26 @ 7:30 am BFH

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