Traffic Safety Specialist Program Designation III Survey

1.Contact Information(Required.)

First Name

Last Name

Rank

Email Address

Phone Number

2.Department / Agency Name(Required.)

3.Do you have at least 3 or more years of Independent Patrol / Traffic experience?(Required.)

Yes

No

Years of service in Law Enforcement?

4.Have you achieved the mandated Traffic Safety Specialist II requirements?(Required.)

Yes (Attach Documentation)

No

5.Traffic Safety Specialist II Documentation(Required.)

No file chosen

6.Have you referred at least three (3) new Traffic Safety Specialist Designation I?(Required.)

Yes

No

7.Provide the names and emails of those you referred to the TSS Program.(Required.)

8.Have you completed a Traffic Safety Project Proposal(Required.)

Yes

No

9.Name of the Traffic Safety Project(Required.)

10.Completed and Approved Traffic Safety Project Documentation(Required.)

No file chosen

Copy and Print the Supervisor Verification Form and have an Executive Officer (Chief, Colonel, or Sheriff) sign. Upload the form into the Supervisor Verification Documentation below.

11.Supervisor Verification Documentation

No file chosen

12.Print the supervisors name and rank in the space below(Required.)

Traffic Safety Specialist Program Designation III

TSS III - Enrollment Form