Please provide the following information for application into the program. Police Department | Explorers Program Application First Name:* Last Name:* Age:* You must be 14 or olderAddress: Street Address City State / Province / Region ZIP / Postal Code Home Phone:Cell Phone:Email Education InformationCurrent High School/College attending: Grade/Level:*Select one:8th Grade9th Grade10th Grade11th Grade12th GradeGraduatedGPA: If graduated - High School last attended: High School Diploma Yes No GED: Yes No Employment InformationName of Company: Current Employer (or most recent)Position: Working: Full-Time Part-Time Date Started: MM slash DD slash YYYY Date Ended: MM slash DD slash YYYY Medical Information:Please list any medical conditions you have:Additional Information:Have you ever been arrested, charged with a crime, or listed as a suspect in a criminal case? Yes No If yes, what were the charges or circumstances?If yes, by what Police Department/Agency: What was the outcome of the charge? (Dismissed, probation, Community Service, etc.)Parent/Guardian Information (if under 18)Parent/Guardian Name: Home Address: Street Address City State / Province / Region ZIP / Postal Code Home Phone:Cell Phone:Email PhoneThis field is for validation purposes and should be left unchanged. Share this story email icon. Click to share on email twitter icon. Click to share on twitter facebook icon. Click to share on facebook linkedIn Icon. Click to share on LinkedIn
