Language
English (US)
South Carolina Criminal Justice Academy
Psychological Testing Reimbursement Form
Date
-
Month
-
Day
Year
Date
Applicant Name
*
First Name
Middle Name
Last Name
Suffix
Last 4 of applicants Social Security Number:
*
Will the applicant be hired as a Class 1 Officer by your agency?
*
Yes
No
If hired, Date of hire
-
Month
-
Day
Year
Date
Agency Name
*
10th Judicial Circuit Solicitor
11th Judicial Circuit Solicitor
12th Judicial Circuit Solicitor
13th Judicial Circuit Solicitor
14th Judicial Circuit Solicitor
15th Judicial Circuit Solicitor
16th Judicial Circuit Solicitor
1st Judicial Circuit Solicitor
2nd Judicial Circuit Solicitor
4th Judicial Circuit Solicitor
5th Judicial Circuit Solicitor
7th Judicial Circuit Solicitor
8th Judicial Circuit Solicitor
9th Judicial Circuit Solicitor
Abbeville Co. Sheriff's Office
Abbeville Police Dept.
Aiken Co. Sheriff's Office
Aiken County Magistrates
Aiken Public Safety
Allen University PS Department
Allendale Co. Sheriff's Office
Allendale Police Dept.
Anderson Co. Fire Protection Commission
Anderson Co. Sheriff's Office
Anderson Fire Department
Anderson Police Dept.
Andrews Police Dept.
Atlantic Beach Police Dept.
Aynor Police Dept.
Bamberg Co. Sheriff's Office
Bamberg Police Dept.
Barnwell Co. Sheriff's Office
Barnwell Police Dept.
Batesburg/Leesville Police Dept.
Beaufort Co. Sheriff's Office
Beaufort Police Dept.
Belton Police Dept.
Benedict College Public Safety Dept.
Bennettsville Police Dept.
Berkeley Co. Sheriff's Office
Bethune Police Dept.
Bishopville Police Dept.
Blacksburg Police Dept.
Blackville Police Dept.
Bluffton Police Dept.
Bob Jones University Public Safety
Bonneau Police Dept.
Bowman Police Dept.
Branchville Police Dept.
Briarcliff Acres Police Dept.
Burnettown Police Dept.
Calhoun Co. Sheriff's Office
Calhoun Falls Police Dept.
Camden Police Dept.
Cameron Police Dept.
Campobello Police Dept.
Cayce Public Safety
Centerra-SRS Law Enforcement Department
Central Police Dept.
Chapin Police Dept.
Charleston City Police Dept.
Charleston Co. Aviation Authority
Charleston Co. Sheriff's Office
Cheraw Police Dept.
Cherokee Co. Sheriff's Office
Chesnee Police Dept.
Chester Co. Sheriff's Office
Chester Police Dept.
Chesterfield Co. Sheriff's Office
Chesterfield Police Dept.
Citadel Public Safety
Claflin University Dept of Public Safety
Clarendon Co. Sheriff's Office
Clemson Police Dept.
Clemson University Police Dept.
Clinton Dept. of Public Safety
Clio Police Dept.
Clover Magistrate Court
Clover Police Dept.
Coastal Carolina University PD
College of Charleston Public Safety
Colleton Co. Sheriff's Office
Columbia College Police Dept.
Columbia Housing Authority
Columbia Metro Airport Department of Public Safety
Columbia Police Dept.
Conway Police Dept.
Cottageville Police Dept.
Coward Police Dept.
Cowpens Police Dept.
CSX Transp. Police SS
Darlington Co. Sheriff's Office
Darlington Police Dept.
Denmark Police Dept.
Denmark Tech College Public Safety
Dillon Co. Sheriff's Office
Dillon Police Dept.
Dorchester Co. Sheriff's Office
Due West Police Dept.
Duncan Police Dept.
Easley Police Dept.
Edgefield Co. Sheriff's Office
Edgefield Police Dept.
Edisto Beach Police Dept.
Ehrhardt Police Dept.
Elgin Police Dept.
Elloree Police Dept.
Erskine College Police Department
Estill Police Dept.
Eutawville Police Dept.
Fairfax Police Dept.
Fairfield Co. Sheriff's Office
Fairview/Austin Summary Court
Florence Co. Sheriff's Office
Florence Police Dept.
Florence Regional Airport Police Department
Folly Beach Public Safety
Forest Acres Police Dept.
Fort Lawn Police Dept.
Fort Mill Magistrate Court
Fort Mill Police Dept.
Fountain Inn Police Dept.
Foxville & Northern Railroad
Francis Marion University Police Department
Furman University Police Department
Gaffney Police Dept.
Gaston Police Dept.
Georgetown Co. Sheriff's Office
Georgetown Police Dept.
Gifford Police Dept.
Goose Creek Police Dept.
Great Falls Police Dept.
Greeleyville Police Dept.
Greenville Co. Dept of Public Safety
Greenville Co. Sheriff's Office
Greenville Hosp. System Law Enf. Svc.
Greenville Police Dept.
Greenville Tech. College Campus Police
Greenville/Spartanburg Airport Police
Greenwood Co. Sheriff's Office
Greenwood Police Dept.
Greer Police Dept.
Greer Police Dept. Jail
Hampton Co. Sheriff's Office
Hampton Police Dept.
Hanahan Police Dept.
Hardeeville Police Dept.
Harleyville Police Dept.
Hartsville Police Dept.
Hemingway Police Dept.
Holly Hill Police Dept.
Honea Path Police Dept.
Horry Co. Police Dept.
Horry Co. Sheriff's Office
Inman Police Dept.
Irmo Police Dept.
Isle of Palms Police Dept.
Iva Police Dept.
J. Reuben Long Detention Center
Jackson Police Dept.
Jamestown Police Dept.
Jasper Co. Sheriff's Office
Johnsonville Police Dept.
Johnston Police Dept.
Jonesville Police Dept.
Kershaw Co. Sheriff's Office
Kingstree Police Dept.
Lake City Police Dept.
Lake View Police Dept.
Lamar Police Dept.
Lancaster Co. Sheriff's Office
Lancaster Police Dept.
Lander University Public Safety
Landrum Police Dept.
Lane Police Dept.
Latta Police Dept.
Laurens Co. Sheriff's Office
Laurens Police Dept.
Lee Co. Sheriff's Office
Lexington Co. Health Services-Dept.of DPS
Lexington Co. Sheriff's Office
Lexington Police Dept.
Liberty Police Dept.
Loris Police Dept.
Lyman Police Dept.
Manning Police Dept.
Marion Co. Sheriff's Office
Marion Police Dept.
Marlboro Co. Sheriff's Office
Mauldin Police Dept.
McColl Police Dept.
McCormick Co. Sheriff's Office
McCormick Police Dept.
Medical University of S.C. Public Safety
Midlands Tech. College
Moncks Corner Police Dept.
Mt. Pleasant Police Dept.
Mullins Police Dept.
Myrtle Beach Police Dept.
Myrtle Beach Police Dept. Jail
New Ellenton Police Dept.
Newberry Co. Sheriff's Office
Newberry Police Dept.
Nichols Police Dept.
Ninety Six Police Dept.
Norfolk Southern Railway Police Dept.
North Augusta Public Safety
North Charleston Police Dept.
North Greenville Summary Court
North Myrtle Beach Public Safety
North Police Dept.
Norway Police Dept.
Oconee Co. Sheriff's Office
Office of Regulatory Staff
Olanta Police Dept.
Olar Police Dept.
Orangeburg Co. Sheriff's Office
Orangeburg Public Safety
Orangeburg/Calhoun Tech. College
Pacolet Police Dept.
Pageland Police Dept.
Pamplico Police Dept.
Pawley's Island Police Dept.
Pelion Police Dept.
Pendleton Police Dept.
Perry Police Dept.
Pickens Co. Detention Center
Pickens Co. Sheriff's Office
Pickens Police Dept.
Piedmont Tech College Public Safety
Pine Ridge Police Dept.
Port Royal Police Dept.
Presbyterian College Campus Police Dept.
Prosperity Police Dept.
Quinby Police Dept.
Richland Co. Sheriff's Office
Ridge Spring Police Dept.
Ridgeland Police Dept.
Ridgeville Police Dept.
Ridgeway Police Dept.
Rock Hill Police Dept.
Rowesville Police Department
S.L.E.D.
Salem Police Dept.
Salley Police Dept.
Saluda Co. Sheriff's Office
Saluda Police Dept.
Santee Police Dept.
SC Attorney General's Office
SC Criminal Justice Academy
SC Department of Public Safety
SC Department of Revenue
SC Dept. of Corrections
SC Dept. of Juvenile Justice Police Dept
SC Dept. of Mental Health
SC Dept. of Natural Resources
SC Dept. of Social Services, Atn: Div of Inv
SC DHEC
SC Division of Public Railways Police Dept.
SC Forestry Commission
SC Governor's School for Science & Mathematics PS
SC Governor's School For The Arts P.S.
SC House of Representatives Sgt-At-Arms Ofc
SC Probation, Parole & Pardon Services
SC Public Service Authority LE Div
SC Senate Sergeant at Arms
SC State Ethics Commission
SC State Museum Public Safety
SC State Ports Authority Police Dept.
SC State University Police Department
School for Deaf & Blind Public Safety Dept.
Scranton Police Dept.
Seneca Police Dept.
Simpsonville Police Dept.
Society Hill Police Dept.
South Congaree Police Dept.
Spartanburg Co. Sheriff's Office
Spartanburg Community College Police Dept.
Spartanburg Methodist College Campus Safety
Spartanburg Police Department
Spartanburg Water System
Springdale Police Dept.
St. George Police Dept.
St. Matthews Police Dept.
St. Stephen Police Dept.
Sullivans Island Police Dept.
Summerton Police Dept.
Summerville Police Dept.
Sumter Co. Sheriff's Office
Sumter County Sheriff's Office-Jail Division
Sumter Police Dept.
Surfside Beach Police Department
Swansea Police Dept.
Tega Cay Police Dept.
Timmonsville Police Dept.
Travelers Rest Police Dept.
Trenton Police Dept.
Tri County Technical College Campus Police
Trident Tech College Public Safety
Turbeville Police Dept.
Union Co. Sheriff's Office
Union Public Safety
USC Aiken Police Department
USC Beaufort Police Dept.
USC Law Enforcement & Safety
USC Upstate Police Department
Varnville Police Dept.
Wagener Police Dept.
Walhalla Police Dept.
Walterboro Fire Department
Walterboro Police Department
Ware Shoals Police Dept.
Wellford Police Dept.
West Columbia Police Dept.
West Pelzer Police Dept.
West Union Police Dept.
Westminster Police Dept.
Whitmire Police Dept.
Williamsburg Co. Sheriff's Office
Williamston Police Dept.
Williston Police Dept.
Winnsboro Public Safety
Winthrop University Police Department
Wofford College Public Safety
Woodruff Police Dept.
Yemassee Police Dept.
York Co. Sheriff's Office
York Police Dept.
York Tech College Security
Point of Contact Name
*
First Name
Last Name
Point of Contact Email
example@example.com
Phone Number
-
Area Code
Phone Number
Reimbursement should be mailed to:
*
Agency Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Reimbursement Amount: (Reimbursements are made for the actual cost up to $350.00)
*
Upload copy of bill. This should show the Applicants Name, Doctors Name as well as the cost.
*
By entering your name below, you certify that you are authorized to submit this form and the above information is true and correct:
*
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