Section 1 of 1 in this document

CMPD Ride Along Program Request Form

Please fill out the fields below. Your submission will be processed and handled through the Division in which the Ride Along is requested. Please allow seven (7) business days to properly handle your request.

For individuals of the age of 17 and needing parental consent to participate in a Ride Along, please use the Parental Consent Ride Along form.

Type of Request

Citizen

Citizens On Patrol

Volunteer

Citizen's Academy

Other

Describe Other

Sex / Gender of Applicant

Race / Ethnicity of Applicant

Age of Applicant

State Driver's License was Issued to Applicant

Driver's License Number of Applicant

Contact Phone Number for Applicant

Alternate Contact Phone Number for Applicant

Contact Email Address for Applicant

Relationship of Emergency Contact to Applicant

Emergency Contact Phone Number

Alternate Contact Number for Emergency Contact Person

Division Requested for Ride Along

*Other (Unit or Person)

Requested Shift for Ride Along

Referred to this Program by:

Reason for wanting to do a Ride-Along

The City of Charlotte is committed to making our services and programs accessible to all. Upon request, auxiliary aids, written materials in alternative formats, language access and other reasonable accommodations or modifications will be provided. To make a request, please email RideAlongs@cmpd.org or call 704.432.0428.

Document Signers

- Applicant
- Approving Supervisor

CMPD Ride Along Program Request Form

Type of Request

Full Name of Applicant

Date of Birth of Applicant

Home Address of Applicant

Emergency Contact Person for Applicant

Requested Date for Ride Along