Volunteer Application Form

By entering my name into the below box, I do certify that as of the date indicated below, I am able to meet the following eligibility standards to volunteering with the Charlotte-Mecklenburg Police Department.

In order to be considered as a volunteer, I understand the following items will be required for the application process: Driver's License, DMV Check, Police Record Check, Drug screening to be completed within 48 hours and a Confidentiality Statement. I state that all the information I have given is correct to the best of my knowledge. I understand that my volunteer position may be terminated without my permission.

Volunteer Resources Application

PERSONAL INQUIRY WAIVER: I authorize the Charlotte-Mecklenburg Police Department to examine all records that are necessary to determine my character, reputation, arrest record, and criminal history. All information not otherwise a public record will remain confidential, and will be utilized solely for the evaluation of my qualifications and fitness to be assigned with the Charlotte-Mecklenburg Police Department in a volunteer capacity.

PERSONAL DATA

Title

Enter first, middle, and last name

Enter Nicknames and Maiden Name (if applicable - if not enter N/A)

Enter years at this resident

Cell Phone

Work Phone

Home phone (if different from cell)

Date of birth

Month

Day

Year

Enter City and State of birth place

Driver's License Number and State

Social Security Number

Gender

Race

White

African American

Hispanic

Other

If other, please specify

Height

Weight

Eye color

Hair color

Household Background

Enter First, Middle, Last name; DOB; Relationship

Educational Background

Graduated High School: Enter Name of School, City, State, and graduation Year

Graduated College: Enter Name of School, City, State, and graduation Year

Degree(s) Check all that apply

Associate

BA/BS

MA/MS

PHD

Enter your Major

Volunteer History

List any prior volunteer experience. Provide Agency/Group/Organization and Years

What is your primary reason for volunteering with us?

Health History

The questions contained in this section are utilized solely for background investigation purposes, and will remain strictly confidential.

When alcoholic beverages are used, how many do you consume?

How often do you drink?

Daily

Weeky

Monthly

Special Occasions

Never

Have you ever tried, used, or experimented with Marijuana?

Yes

If yes: enter number of times and date of last use

Have you tried, used, or experimented with heroin?

Yes

Have you ever tried, used, or experimented with cocaine?

Yes

Have you ever tried, used, or experimented with any other illegal substance?

Yes

If Yes: enter name of substance

Have you ever tried, used or experimented with any other controlled substance that was not prescribed by a physician?

Yes

If yes: enter name of substance

Have you ever tried, used or experimented with a prescription medication that was not prescribed for you?

Yes

If yes: enter name of medication

Have you ever tried or used a prescription medication, prescribed for you, when it was not medically necessary?

Yes

If yes: enter name of medication

Military History

Have you ever served in the armed forces?

Yes

If yes: enter month and year from when you started and ended your enlistment. ALSO enter branch, rank, and type of discharge

References

List your most recent employer's business name

Phone Number of contact person

List two personal references who have known you for at least five (5) years. Do not include relatives.

Reference Contact 1 Phone

Reference Contact 1 Email

Reference contact 1's relationship to applicant

Reference Contact 2 Phone

Reference Contact 2 Email

Reference contact 2's relationship to applicant

Criminal History

Have you ever (as an adult or a juvenile) been arrested, detained, or questioned by the police concerning a crime?