Ride Along Application

Applicationt Information

Applicants Full Name:

Address:

Phone Number:

E-Mail:

Occupation:

Employer/ School:

Emergency Contact Information (Who to call in case of emergency)

Name:

Address:

Phone Number:

Relationship:

If Applicant is Under 18, Provide Parent/Guardian's information

Name:

Mother/Stepmother Father/Stepfather Legal Guardian

Address:

Phone:

Reason For Ride Along Request:

Preferred Date and Time of Ride Along:

NOTICE: Participant is required to dress appropriately. Casual business attire is preferred. Jeans are permissible if worn appropriately. Ride-Along may be terminated if clothing is determined to not be appropriate by the patrol supervisor and/or the officer assigned to the Ride-Along. Ride-Along may be denied by a supervisor for any reason or teminated at any time by the assigned officer or the patrol supervisor.

I have read the above statement and agree to the terms

Security Measure