CMPD Volunteer Unit Application
Applicant Information
Other title of respect
Full Name of Applicant
Nicknames
Applicant Address
Address: City
Address: Zip Code
Years at this residence
Mailing Address
Mailing Address: City
Mailing Address: Zip Code
Contact Email Address
Contact Cell Phone Number
Contact Home Phone Number
Contact Work Phone Number
Date of Birth
Place of Birth: City
Place of Birth: State
Social Security Number
Driver's License Number
State Driver's License Issued
Race: Other
Height
Weight
Eye Color
Hair Color
Household Background
List of People Residing in your Household
Educational Background
Name of High School, City and State
Years of High School Completed
Name of College, City and State
Years of College Completed
Major
Graduate Studies: Name of School, City and State
Years of Graduate Studies Completed
Additional Major
Additional Studies: Name of School, City and State
Years of Additional Studies Completed
Volunteer History
List any Prior Volunteer Experience
What is your primary reason for volunteering with us?
Health Screening History
Which alcoholic beverages are used and how many do you consume?
If yes to marijuana, how many times and what was the last date used?
If yes to illegal substances, please provide the name of the substance
Military History
Enlistment start date
Enlistment end date
Branch of military and Rank
Type of Discharge
References
Most Recent Employer
Name of Business
Street Address of Business
City / State / Zip Code of Business
Business Contact Name and Phone Number
Personal References
List three personal references who have known you for at least five (05) years. DO NOT INCLUDE RELATIVES.
Personal Reference 01
PR01: Address
PR01: City / State / Zip Code
PR01: Home and Work Phone Numbers
PR01: Contact email address
PR01: Relationship to Applicant
Personal Reference 02
PR02: Address
PR02: City / State / Zip Code
PR02: Home and Work phone numbers
PR02: Contact Email Address
PR02: Relationship to Applicant
Personal Reference 03
PR03: Address
PR03: City / State / Zip Code
PR03: Home and Work phone numbers
PR03: Contact Email Address
PR03: Relationship to Applicant
Criminal History
Upload Attachment for Arrest of a Crime
Upload Attachment for Driving Privileges
Upload Attachment for Traffic Citation
Upload Attachment for Serious Crime for which you were NOT arrested
For Office Use ONLY
Volunteer Interest Form
What other skills and/or experience do you possess?
What do you expect to gain from volunteering with CMPD?
What days and times are convenient for you to volunteer?
Do you have a specific Division / Unit location where you would like to volunteer?
Emergency Contacts
Name of Emergency Contact 01
EC01: Address, City, State and Zip Code
EC01: Home Phone Number
EC01: Work Phone Number
EC01: Cell Phone Number
EC01: Contact Email Address
EC01: Relationship to Applicant
Name of Emergency Contact 02
EC02: Address, City, State and Zip Code
EC02: Home Phone Number
EC02: Work Phone Number
EC02: Cell Phone Number
EC02: Contact Email Address
EC02: Relationship to Applicant
Name of Emergency Contact 03
EC03: Address, City, State and Zip Code
EC03: Home Phone Number
EC03: Work Phone Number
EC03: Cell Phone Number
EC03: Contact Email Address
EC03: Relationship to Applicant
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 Officer Antoine Patterson , Volunteer Liaison Officer or call 704-353-0302 ext. 1 .
