BOGOTA AUXILIARY POLICE
Membership Application
Date of
Application:_______________
S.S.#:_____________________________________________ Phone#:
________________________________________
How
long have you been a resident of the Borough of Bogota:
_______________________________________________
Residence
10 years prior to Bogota:______________________________________________________________________
Name
of Employer: _____________________________________________________ Job Title:
_____________________
Address:
_________________________________________________________________ Phone#:___________________
(If
self-employed) Name of Business:
____________________________________________________________________
Address:
_________________________________________________________________
Phone#:___________________
Are
you a citizen?: _____________________
Married?: _________________________ Children?: ________________
Date
of Birth: ___________________ Where?:
_________________________________ Age: _____________________
Height:
________________________ Weight:
__________________________________ Wear glasses? _____________
Time
normally available for Auxiliary duty in Bogota:
_____________________________________________________
Have
you ever been convicted of a crime or do you have a police record?:
______________ If yes, explain: _________
____________________________________________________________________________________________________
Do
you drive?: ______________ If yes,
license #: __________________________________________________________
Do
you have any moving violations on your driving record?: _________________ If yes, explain: _________________
____________________________________________________________________________________________________
Have
you any special skills or knowledge that may be useful in Auxiliary Police
work? __________________________
If
yes, explain:
_______________________________________________________________________________________
____________________________________________________________________________________________________
Military
service: _______________ If yes, rank held:
_______________________________________________________
Do
you have any physical disabilities?: ______________ If yes, explain:
_______________________________________
____________________________________________________________________________________________________
Have
you ever been under the care of a psychiatrist?: ______________ If yes, explain: __________________________
____________________________________________________________________________________________________
On
the reverse side of this application, explain your interest in becoming a
police Officer with the Bogota Auxiliary
Police
Department.
I
swear the above statements are true and I also give my consent to the Bogota
Police Department to conduct an
Extensive
background investigation:
Signature: _________________________________________________