HomeMy WebLinkAboutVII (A) Discussion/Authorization to Implement a Citizens Police Academy Agenda 10-02-2001
Item VII A
'1'0: The Honorable Mayor and Board Q'City Commissioners
FROM: Robert E. Mark, Chief of Police / =
DATE: September 26, 2001
SUBJECT: AUTHORIZATION TO IMPLEMENT A CITIZENS POLICE ACADEMY
STAFF REPORT
ISSUE
Should the Honorable Mayor and Board of City Commissioners authorize the Police
Department to offer to those who live and work in the City of Ocoee the opportunity to
better understand the functions and responsibilities of the Police Department, as well as the
opportunity to demonstrate how citizens can help, by allowing the Ocoee Police Department
to implement a Citizens Police Academy?
BACKGROUND
The City of Ocoee, as well as the Police Department, is dedicated to offering citizens the best
possible services while at the same time encouraging citizens to become more involved with
the issues facing their own community. Consistent with those goals, the City of Ocoee Police
Department requests permission to offer a Citizens Police Academy.
The Citizen Police Academy will he an eight-week, sixteen-hour program, with students
meeting once a week for two hours per night. 'Phis program will be offered at no cost to city
residents and police department volunteers, and those who work in, or for, the city can fill
spaces if available (recommended class size of twenty). A ride-along will be offered to
students after the fourth week of instruction, but students will not be required to participate.
Also, other off-site field trips may he planned, but attendance will not be required. At the
end of the eight-week program, students will be given a Certificate of Participation signed by
the program coordinator and the Chief of Police (See Proposed Certificate of Participation:
Appendix A). This program (the eight-week class) can be offered as often as interest and
funds permit. The tentative topics for discussion include, but are not limited to:
Crime Prevention laws and Crimes Drug Recognition
Police Equipment Traffic Enforcement Use of Force
Traffic Control DUI Investigations Defensive Tactics
Domestic Violence Fingerprints Firearm Safety
US Constitution Evidence Firearm Laws
It should be made very clear that this program is not intended to certify yone as a law
enforcement officer nor is it intended to encourage citizens to take any polic ction.
STAFF REPORT
CITIZEN POLICE ACADEMY
SEPTEMBER 26, 2001
PAGE 2
RESEARCH & DEVELOPMENT
Orlando Police, Orange County Sheriffs Office, and Apopka Police are three local agencies
that have all enjoyed the benefits of offering such programs. In researching this program
and developing program materials, seven Citizen Police Academies both inside and outside
Orange County and some outside the State of Florida were examined. Two agencies were
visited in order to speak with their program coordinators and to obtain samples of program
materials. Ocoee, like these other cities that have implemented such programs, can enjoy
benefits such as:
1) Fostering positive relations with those who live and work in the city.
2) Providing introductory training fir the Police Chaplain Program.
3) Creating an environment to better evaluate possible employment candidates.
4) Educating citizens on crime prevention techniques.
5) Building a pool of possible volunteers to assist in agency tasks such as
fingerprinting, back up crossing guards, and to assist in traffic control for
scheduled events and during emergencies.
6) Promoting goodwill with citizens and other city departments.
7) Creating the possibility of the agency, and the city, receiving positive media
coverage.
8) Educating those in key positions to the unique issues facing law enforcement so
that they can provide services better suited to the Ocoee Police Department.
Examples of these people might include Information Systems Staff,
Communications Staff, as well as those services outside the city such as E-911.
DISCUSSION
In order to offer the best possible program, the Citizen Police Academy program
coordinator will require permission to complete certain tasks. 'The tasks necessary to offer
this program include, but are not limited to:
•b Soliciting sponsorship (See proposed Sponsorship Letter: Appendix B)
•I• Recognizing sponsors (See proposed Sponsorship Letter: Appendix B)
.I• Managing and administrating the funds to be spent on program expenses, consistent
with all city rules and regulations
:• Designing program materials such as flyers, certificates, logos, and handouts (See
Proposed Program Flyer: Appendix C)
STAFF REPORT
CITIZEN POLICE ACADEMY
SEPTEMBER 26, 2001
PAGE 3
• Advertising the program on the city television station as well as other available
methods (See proposed City Television Advertisement: Appendix D)
• Arranging for an agency approved press release when appropriate (to be done by a
Police Department Press Information Officer (P.1.O.) consistent with all department
and city guidelines)
+ Securing a city location for the classroom sessions (preferably the city commission
chambers on a night of the week when all eight classes can be held)
C. Recruiting instructors from both inside and outside the agency
• Any activity reasonably necessary to achieve program goals
Proposed Costs:
It is the intention of the program to provide each student with a minimum of program
binder (3-ring notebook), a collared T-shirt with program logo, refreshments, and the
opportunity to observe a firearm demonstration. The following are the minimum estimated
costs:
T-shirt $ 15.00 X20 students $ 300.00
Program binder.... $ 3.00 .. X20 students $ 60.00
Refreshments $ 5.00 X8 weeks $ 40.00
Total Expenses: $ 400.00 (per session)
Funds raised in excess of that required will be used to purchase miscellaneous supplies, shirts
for instructors and supporters, on the final class ceremony and/or banquet, and/or held in an
account to be used for future classes. Funds not spent on this program can only be spent on
other Police Department programs with the express permission of the city commission.
RECOMMENDATION
The program coordinator for the Citizen Police Academy shall be Officer Thomas Maroney
who will be operating this program under Sergeant James Como, the Head Press
Information Officer for the Police Department. In this capacity, Officer Maroney will act as a
volunteer, with these duties not interfering with his duties as a police officer. Further,
officers or other Police Department staff, who teach at the Citizen Police Academy will either
volunteer their time or flex shift time, with the permission of their supervisor.
The Police Department currently has a Standard Operating Procedure covering observer
eligibility requirements and restrictions (See SOP 44: Appendix E). This policy regulates all
STAFF REPORT
CITIZEN POLICE ACADEMY
SEPTEMBER 26, 2001
PAGE 4
aspects of the ride-along program and includes a waiver form for citizens, city employees,
and law enforcement officers from other jurisdictions. Since one ride-along is part of this
program, this eight-week Citizen Police Academy, with the one ride-along, should be treated
as one extended ride-along, adhering to all current and future policies. Further the
program coordinator or the Chief of Police has the option to make program guidelines
more restrictive than the current policy.
Exceptions and/or additions to the SOP 41 for the Citizen Police Academy:
The wavier required for the ride-along and fur attendance in die Citizen Police Academy
has been combined into one (See Proposed Waiver: Appendix F). In addition to the exact
language of the original, restrictions have been placed on the use of cameras, the rider's
requirement to stay in police vehicles during all traffic stops, and range activity.
Please consider this program as an opportunity to improve police-citizen relations, to
promote positive police-citizen contacts, and to educate our citizens about issues facing
our Police Department and our City. It is respectfully recommended that the Honorable
Mayor and Board of City Commissioners approve this request to implement a Citizens
Police Academy
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POLICE
City of Ocoee Police Department ift
Citizen Police Academy
175 N. Bluford Ave.
Ocoee, FL 34761
29 September 2001
Dear:
As part of our mission to educate those who live and work in the city about the issues facing Law
Enforcement, the City of Ocoee Police Department will be offering a Citizen Police Academy. Citizens
will be provided with a basic understanding of the Law Enforcement function as well as how officers
detect violations and enforce laws. The Citizen Police Academy will be an eight week 16 hour block of
instruction with topics to include:
Crime Prevention Laws & Crimes Drug Recognition
Police Equipment Traffic Enforcement Use of Force
Traffic Control DUI Investigations Defensive Tactics
Code Responses Fingerprints Firearm Safety
US Constitution Evidence And More....
Each class will cost approximately Five hundred dollars, and we are seeking donations from local
companies to cover these costs. Your donation will be spent on program binders and handouts, 'f-shirts
for participants and instructors, graduation certificates, identification badges to be worn during a ride-
along, firearm ammunition, refreshments, and miscellaneous supplies. The program will be offered at no
cost to city residents, and those who work in the city will be permitted to fill available spaces.
Benefits of Sponsorship:
For a donation of$500 (to sponsor an entire class):
Your Company name and/or logo on City TV Bulletin board to thank you for your support
Your Company name and/or logo on the participants' T-shirts
Attendance at the graduation
And all benefits listed below
For a donation of$100:
Your Company name and/or logo on the program pamphlets to advertise for the program
Your Company's advertisement and/or coupons placed into the program binder
And all benefits listed below
For a donation of$50:
Your Company name and/or logo on the cover of the program binder
Certificate of appreciation from the Chief of Police
Thank you for any help that you can provide towards the realization of this worth while project.
Sincerely yours,
Ofc. Tom Maroney, MBA
Citizen Police Academy Coordinator
407 905 3163 nx_3381
Imaroncyaici ococe.1]us
REGISTRATION FORM ' ! I 1
The City of Ocoee
LAST NAME FIRST MI. Cain Police Academy
PLEASE CHECK ALL THAT APPLY CITY OF OCOEE
is Free Public
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DepartmentDepartmentand the '.
HOME ADDRESS generous donations from
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DATE OF BIRTH SOC. SEC #
Name and Logo October 25`" -December 13'
7:00 PM -9:OOPM
HOME PHONE WORK PHONE here
ADDRESS OF EMPLOYMENT .z..�
EMERGENCY CONTACT NAME FOR MORE INFORMATION, CONTACT:
OFC. TOM MARONEY 7-1/
EMERGENCY CONTACT PHONE 175 N. BLUFORD AVE ti`
OCOEE, FL 34761 t
SIGNATURE DATE (407) 656-1518 EX 3381
PLEASE WEAR CASUAL ATTIRE EMAIL TMARONEY@CLOCOEE.FL.US I I I—
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❖ Learn why police conduct traffic WHAT THE CITIZEN POLICE WHAT TOPICS WILL -
stops the way they do. ACADEMY IS NOT 9
:• Learn how police conduct DUI BE DISCUSSED.
The Citizen Police Academy is not
investigations. intended to Certify Law Enforcement
1• Learn about the equipment Officers nor is it intended to teach citizens Tentative Class Schedule:
police use to do their job. to take any police action. Week One:
+ Learn the difference between WHEN DOES THE CLASS • Program& Department Overview
civil and criminal law. Main Functional Areas
• Learn about Defensive Tactics MEET? t• Station Tour
and the agency's Use of Force The City Of Ocoee Citizen Police Academy Week Two:
Policies. meets once a week on Thursday evenings • Equipment(Personal, Vehicle, Special)
:• Learn aboutpolice work by from 7:00 p.m. to 9:00 p.m. Students will + Traffic Control
meet weekly for eight weeks. Officers. ••• Cade Responses
riding along with a police officer. supervisors, and professionals in all areas of Week Three:
law enforcement will teach each two-hour ♦ US Constitution(Bill of Rights)
WHAT IS THE CITIZEN block of instruction. t• Law&Crimes
POLICE ACADEMY? Week Four:
HOW DO I SIGN UP? :• Traffic Enforcement
The City of Ocoee Citizen Police Du Investigations
Simply fill out the application on the back of '•. g
Academy is an eight-week block of this pamphlet. Return the completed Week Five:
instruction designed to give the application to the City of Ocoee Police r Evidence
Department. This class is held at no cost to et. Drug Recognition
Ocoee community an inside look at the participants. ••• Fingerprints& Fingerprinting
the duties of a law enforcement Week Six:
officer. WHO CAN PARTICIPATE? :• Use of Force
.• Defensive Tactics
Through the use of lectures, Citizens of the City of Ocoee will fill i• Shoot-Don't Shoot
available spaces first. followed by those who Week Seven:
demonstrations, tours, and hands-on work in the City of Ocoee. Those who do
is not live or work in the city will only be Firearm Laws and Safety
opportunities, citizens will gain • Firearm Demonstration
admitted if space is available. City of Ocoee
valuable insight into the type of employees are eligible to attend. Those with Week Eight:
is
work done by officers of the City of a felony record or misdemeanor involving a crime Prevention
false statement, violence, or sexual • Neighborhood Watch
Ocoee Police Department. misconduct are ineligible to participate in Graduation
this program. Other restrictions may apply. Topics are subject to change due to fl
instructor or resource availability. yJ
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OCOEE POLICE DEPARTMENT Date of Issue Effective Date Number
STANDARD OPERATING PROCEDURES 05-19-98 05-19-98 44
Subject Reference
OBSERVER PROGRAM
Amended Rescinds Revised
CONTENTS: This order consists of the following numbered sections:
I. OBSERVER ELIGIBILITY REQUIREMENTS AND RESTRICTIONS
II. WATCH COMMANDER RESPONSIBILITIES
III. OFFICER RESPONSIBILITIES
IV. OBSERVER PROGRAM COORDINATOR RESPONSIBILITIES
22. V. GLOSSARY
PURPOSE:
The purpose of this order is to provide procedures for officers, supervisors, and watch
commanders regarding the Observer Program.
SCOPE:
This order applies to all members of the Ocoee Police Department.
DISCUSSION:
Requests are generated from individuals desiring to learn about patrol activities through first
hand observation by accompanying an officer while on patrol. Because of the nature of police
functions and the possible dangers involved in daily duties, it is necessary to ensure that all
request are valid and properly screened. For this purpose the citizen observer and information
record forms are utilized.
I. OBSERVER ELIGIBILITY REQUIREMENTS AND RESTRICTIONS:
A. The following individuals, upon approval of the watch commander (or higher
authority), are authorized to ride as observers:
1. Law enforcement officers from other agencies;
SOP
# 44
Page 2 of 9
2. City employees (with their supervisor's approval) who can demonstrate
that the experience gained from riding as an observer would benefit the
City;
3. Persons who have completed the screening process for the position of
police officer with the City of Ocoee;
4. Members of the media(prior approval of the Chief of Police is required);
5. Those individuals who have a sincere desire to gain more knowledge
about the police mission and have objectives compatible with those of the
City of Ocoee Police Department.
6. Members of the Ocoee Police Department shall not be allowed to have a
spouse or significant other ride with then'.
B. Requests to observe/ride with a particular officer are subject to the approval of the
officer's supervisor.
C. Observers arc required to do the following:
1. Submit their completed Observer Program Request/Release Form to the
Observer Program Coordinator (O.P.C.) five (5) days prior to the date on
which they wish to ride (Form A). Officers from other agencies must
complete forms A and B. Employer Authorization form (Form B) must be
signed by the officers department director or designee.
2. Agree to abide by the following rules;
a. Observers shall report to the appropriate field supervisor at the
designated assembly site fifteen minutes prior to start of shift.
b. Observers shall be neat and clean in appearance and attire. The
field supervisor shall make decisions regarding questionable attire
or appearance. Observers not appropriately attired will not be
allowed to ride.
c. Observers have no police authority and are under the direct
authority of the police officer to which they are assigned.
d. Observers shall not interfere with any police officers performing
their duty.
e. Observers shall not:
SOP
# 44
Page 3 of 9
I) Become involved in any investigation,
2) handle evidence,
3) Discuss any case with victim(s), witnesses or suspect(s),
4) Handle police equipment.
f. Observers shall abide by their host officer's decision as to whether
or not they will be allowed to exit the vehicle and observe
particular calls for police service.
g. Observers are allowed to take notes, but shall not bring nor use
tape recorders, cameras or video equipment (credentialed media
representatives may be exempt from this rule)
h. Observers are to understand that they may be called to court as a
witness as a result of participating in the program.
i. Observers, host officers, or supervisors may temtinate the ride-
along at any time it is deemed necessary to benefit the observer
and/or the City of Ocoee Police Department.
j. Observers, once approved, are permitted to ride one time within
any 3-month period unless otherwise approved by the Executive
Officer or designee.
k. Observers shall be unarmed unless they are certified Florida police
officers and are authorized by the Chief of Police to he armed.
D. The following restrictions shall apply to observers:
1. Observers shall be at least 16 years of age (those observers under
18 years of age shall have their parents' or legal guardian's
notarized written consent prior to riding); and
2. Observers on (mid-night shift) shall be of the same gender as their
host officer.
II. WATCH COMMANDER RESPONSIBILITIES:
A. Once a request to observe is received, the supervisor shall, prior to approving the
request, ensure that the Observer Program Request/Release Form is properly
P L tl•
it
SOP
k 44
Page 4 of 9
completed. The supervisor shall then forward the forms via the chain of command
to the Observer Program Coordinator for approval.
B. Supervisors are responsible for assigning the observer to an officer, once the
observer has been approved by the O.P.C. using the following procedures:
1. Officers shall have completed their probationary period;
2. Staff shall consult with the officer's supervisor to determine if the
supervisor has any objections to the observer or officer participating in the
program;
3. Supervisors assigning observers will confer with the officer assigned an
observer and determine if the officer has any objections to being a host
officer for an observer. The objection shall be documented by the officer
and honored by the supervisor; and
4. Observers names shall be noted on the daily roll call. It shall be the watch
commander's discretion whether to allow the observer to attend roll call.
C. Supervisors will place completed Observer Request Forms on the Observer Form
clipboard located in watch commander's office.
III. OFFICER RESPONSIBILITIES:
A. Individual officers initiating requests for observers shall submit a completed
Observer Program Request/Release Form to their supervisor for approval. Upon
approval, the supervisor shall forward the form to the Observer Program
Coordinator for final approval. The Observer Program Coordinator approving the
form shall forward it to records for filing purposes.
B. Officers with observers shall ensure that the observer is familiar with the
requirements and restrictions of observers as outlined in Article I.
C. Officers shall use good judgment in allowing the observer to view dangerous
situations. If in the officer's opinion the incident is too dangerous to ensure the
officer's safety and that of the observer, the observer shall be left at a secure
location and picked up as soon as the danger has been eliminated.
D. Officers, while en route to calls, shall attempt to brief the observer as to what
information is being received on the police radio and explain the procedures to be
applied to the call and why.
SOP
#44
Page5 of 9
E. Officers shall permit the observer to view as much activity as possible and shall
not restrict the observer to the confines of the patrol car unless the officer feels
• there is some danger or that the observer may interfere with the investigation.
1V. OBSERVER PROGRAM COORDINATOR RESPONSIBILITIES:
A. The patrol division commander is designated the Observer Program Coordinator.
It shall be the responsibility of the Observer Program Coordinator (O.P.C.) to
review and process all requests from would be participants in the program. This
processing shall include:
1. Interviewing applicants to determine their suitability for the program;
2. Ensuring that the Observer Program Request/Release Form is properly
completed; and
3. Ensure that the Information Record Request form is properly completed; a
criminal history check will be conducted on all observers except City of
Ocoee employees. This shall be completed by the O.P.C.
B. The O.P.C. will schedule the observer several days in advance in order to allow
the appropriate supervisor to make assignment with an officer and adjust the
schedule so as to denote the observer.
C. A copy of the Observer Program Request/Release Form, which has been
processed and approved by the O.P.C., shall be forwarded to the appropriate
supervisor for officer assignment and roll call amendments.
_ ll. "fhe O.Y.C. will be available to receive and maintain records regarding any
information from supervisors or other members which may eliminate or terminate
an observer's privilege or riding with an officer.
V. GLOSSARY
OBSERVER- any person that is not a member of the Ocoee Police Department.
OBSERVER PROGRAM COORDINATOR - The Patrol Commander is designated for this
position and is responsible for the assuring that all facets of this policy and program are
consummated.
l'
SOP
# 44
Page 6 of 9
NOTE: Members of the Ocoee Police Auxiliary, Ocoee Police Chaplains, Ocoee Police
Explorer Scouts programs and City of Ocoee Mayor and Commissioners are exempt from the
provisions of this order.
By Order Of
Robert E. Mark
Chief of Police
Form A
CITIZEN OBSERVER
Release and Waiver
I, , for and in consideration of the City of Ocoee allowing me to participate in a
Police Ride-Along Program which entitles me to he present in Ocoee Police patrol vehicles during the actual
working hours of police officers on patrol, and to be present in the Police station and observe the activities of the
Police Department, do hereby agree as follows:
I. I acknowledge and understand that by participating in this program, I am exposing myself to all risks normally
associated with police activity,and I expressly assume such risks.
2. I understand that while participating in this program I will be assigned to one or more police officers and I agree
that I will,at all times, follow the instructions and obey commands issued by those
officers or by superior officers.
3. I further understand that I am responsible for conducting myself in the following manner:
a. I shall at all times be clean and neatly dressed. Where questions arise pertaining to suitability of attire,a
supervisor will make the final decision.
b. I shall be issued an observer's clip-on identification card to be worn in full view on the outside of the
clothing.
• c. At the conclusion of the ride, I will return the identification card to the duty officer and complete the
comments section of the Observer Ride-Along form.
d. I shall not carry or possess weapons of any kind while participating as an observer in the Ride-
Along Program.
I am a sworn officer whose jurisdiction includes the City of Ocoee and I am authorized by my
employer, , to carry weapons and take any necessary police action
while participating as an observer in the Ride-Along Program. (Employer Authorization and
Acknowledgment form must be attached).
I am a sworn officer whose jurisdiction includes the City of Ocoee, but I am not authorized by my
employer, , to carry weapons or undertake any police action while
participating as an observer in the Ride-Along Program.
SOP
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Page 7 of 9
4. On behalf of myself,my heirs,executors,and assigns,I do hereby release and forever discharge the City
of Ocoee and its agents, officers, and employees of and from all manner of action and actions cause of
causes of action, suits, debts, claims, damages or injuries, whatsoever in law or equity which I might have
against the City of Ocoee, its agents, employees, officers and assigns by reason of any cause or thing
whatever.
Observer Parent or Guardian, if observer is under
the age of 18.
Officer Witness
SOP
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Page 8 of 9
Form B
LAW ENFORCEMENT OBSERVER
EMPLOYER AUTHORIZATION
AND
ACKNOWLEDGMENT OF POTENTIAL LIABILITY
I hereby authorize to participate in the Ocoee Police
(Name of Officer)
Department Ride Along Program. I certify that _ is a
(Name of Officer)
sworn law enforcement officer, in good standing with this department, who is authorized and
qualified to carry a concealed weapon/firearm within the City of Ocoee, Florida. On behalf
of the , I understand and acknowledge that if
(Name of Employee's Agency)
undertakes a law enforcement action,
(Name of Officer)
such action may result in liability to the employee and the employing agency.
Department Director or Designee
Print Name
Date
(� �/
SOP
# 44
Page 9 of 9
Form C
OCOEE POLICE DEPARTMENT
RIDER PROGRAM INFORMATION RECORD FORM
APPROVED
DISAPPROVED
Name: Sex DOB / /
Social Security# / / Drivers License#
Address Phone
Street Apt. City State Zip
Place of Employment Phone
Emergency Contact (Name) Phone
Law Enforcement Officer? Yes No
Have you ever been CHARGED OR CONVICTED of any crime?
With whom do you wish to ride?
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Application checked by Date / /
DESCRIPTOR FILE: QI: QH: QD:
FAILURE TO ANSWER TRUTHFULLY MAY RESULT IN BEING DENIED PERMISSION TO RIDE.
City Of Ocoee Police Department
Citizen Police Academy Program
Release & Waiver
1, , for and in consideration of the City of Ocoee Police allowing me to
participate in the Citizen Police Academy Program,which entitles me to be present in Ocoee Police patrol vehicles during
the actual working hours of the police officers on patrol,and to be present in the Police station and observe the activities of
the Police Department,and to be present on the Police firearm range,do hereby agree to the following:
I) I acknowledge and understand that by participating in this program, I am exposing myself to all risks associated with
police activity,and I expressly assume all risks.
2) I understand that while participating in this prog am, I may be assigned to one or more police officers,and I agree to,at
all times, follow all instructions and obey all commands issued by the officers or their supervisors.
3) I further understand that I am responsible for conducting myself in the following manner:
A) I shall at all limes be clean and neatly dressed. Where questions arise pertaining to suitability of attire, the
supervisor will make the final decision.
B) I shall be issued an observer clip-on identification card to he worn in hill view on the outside of the clothing
during ride along activities.
C) At the conclusion of the ride, I will return the identification card to the duty officer.
D) I SHALL NOT CARRY OR POSSESS A WEAPON OR ANY KIND while participating as an
observer in the Citizen Police Academy Program.
E) I shall NOT be permitted to bring a camera on the ride-along.
F) I understand that during all traffic stops, and whenever commanded to do so, I must remain in the police vehicle
unless otherwise instructed by the officer or supervisor.
4) While present on the police firearm range, I understand that:
A) I shall exactly obey all commands and safety instructions issued by officers or supervisors.
B) I SHALL NOT BRING ANY WEAPONS ONTO THE POLICE RANGE.
C) I shall only be permitted on the police range during scheduled training and only while accompanied by an officer
or supervisor.
5) On behalf of myself,my heirs,executors,and assigns, I do hereby release and forever discharge the City Of Ocoee and
its agents, officers, and employees of and from all manner of actions cause of causes of action, suits, debts, claims,
damages or injuries,whatsoever in law or equity which I might have against the City of Ocoee, its agents, employees,
officers and assigns by reason of any causes or thing whatsoever.
Observer' Signature Witness's Signature
_ _..._
Officer's Signature
Name(Printed) Sex: Race: DOB: / /
Social Security 4: / / Drivers License 4:
Address: Phone 4:
Street Apt. City State Zip
Place of Employment: Phone 14
Emergency Contact(Name): Phone 14:
Law Enforcement Officer? Yes No
I lave you ever been CHARGED OR CONVICTED of any crime?(Other than Traffic)
FAILURE TO ANSWER TRUTHFULLY MAY RESULT IN BEING DENIED PERMISSION TO PARTICIPATE.
•
Please do not write in this area- For official use only.
Application checked by Date
DESCRIPTOR FILE: QI: QI I: QD:
APPROVED DISAPPROVED