CMPD Ride Along Program Request Form (Parental Consent)

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.

Type of Request

CMPD Police Explorer

Citizen

Citizens On Patrol

Volunteer

Citizen's Academy

Other

CMPD Intern

CMPD Cadet

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

Document Signers

- Applicant
- Parent Signature
- Approving Supervisor