Volunteer Patrol Application
PLEASE PRINT OR TYPE
Applicants must be at least 18 years of age. The Tampa Police Department seeks toinvolve qualified adult citizens in the Neighborhood Watch Citizens on Patrol, withoutregard to race, sex, age, national origin, religious affiliation, or ethnicity. Applicants with prior felony convictions, recent DUI convictions, or recent illegal drug use will notqualify to serve. The Tampa Police Department will conduct a criminal records check onall applications prior to approval. Incomplete or unsigned applications will not beconsidered.
PERSONAL
Name (Last, First, Middle)__________________________________________________ Street Address____________________________________________________________ City, State, Zip Code_______________________________________________________ Date of Birth_________________________ Home Phone_________________________ Florida Drivers License Number or Florida I.D.#_____________________________________________ E-Mail Address___________________________________________________________ Are you Employed in Tampa? Yes____ No______ If so how long? ________________
EDUCATION
High School Graduate?___________ GED?_________ College Graduate?_________ Name of High School______________________________________________________ Do you speak a second language?________ If so, what language?_______________
BACKGROUND
Have you ever been arrested for, convicted of, or cited for any offense other than traffic?YES________ NO__________.
If YES, on a separate sheet of paper
please explain indetail, listing appropriate dates, charges, places, and action taken.
REFERENCES
Are you retired?______Yes _________ No Former Occupation ________________ Present/Previous Employer__________________________________________________ Name of Supervisor_______________________________________________________ Address_________________________________________________________________ Telephone _______________________________________________________________
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