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601 E. Trade Street Charlotte, NC 28202

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

Full Name of Applicant

Date of Birth of Applicant

Home Address of Applicant

Emergency Contact Person for Applicant

Requested Date for Ride Along