CLAYTON POLICE DEPARTMENT
VOLUNTEER APPLICATION

Return to:


Phone:
Fax:

Clayton Police Department
6000 Heritage Trail
Clayton, CA 94517
(925) 673-7350
(925) 672-1429

The City of Clayton is an Equal Opportunity Employer and hires on the basis of qualifications (training and experience), and ability to perform effectively int eh specified position. We do not and will not discriminate on the basis of race, color, religion, gender, etc., nor for disabilities that can reasonably be accommodated.

NAME ___________________________________________________________________________________________
ADDRESS ________________________________________________________________________________________
CITY STATE ZIP __________________________________________________________________________________
PHONE: HOME __________________________ WORK ___________________________ CELL _________________
EMAIL _____________________________________ DRIVER'S LICENSE/STATE ____________________________
 
Where did you hear about Clayton Police Department's volunteer opportunities: ___________________________________
__________________________________________________________________________________________________
EXPERIENCE

Describe fully any job related skills, knowledge, special training, certificates, registrations or licenses you may possess or machines/equipment that you can operate which might apply to volunteer assignments: _____________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

Other languages spoken: ______________________________________________________________________________

Computer programs you can use: _______________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Please list any information about yourself such as hobbies and interests: _________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

EXPERIENCE
Please describe any work experience, volunteer work, or other life experiences which would apply to a volunteer assignment at the Police Department: _____________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
LIMITATIONS
Are there any physical conditions we whould consider in arranging volunteer assignments for you? ____________________
If "yes", please explain: _______________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
When are you able to volunteer? Time of Day/Day of Week/Amount of Time: ____________________________________
__________________________________________________________________________________________________
EMERGENCY CONTACT
NAME __________________________________________________________RELATIONSHIP ___________________
ADDRESS _________________________________________________________________________________________
CITY/STATE/ZIP ___________________________________________________________________________________
HOME PHONE _______________________________________ WORK PHONE _______________________________
CELL PHONE ________________________________________ OTHER ______________________________________

CERTIFICATE OF APPLICANT

I certify that the information shown is true, complete and correct to the best of my knowledge, and that misstatements may subject me to disqualification or dismissal. I further understand any or all information included on this application is subject to verification by the City of Clayton.

Signature _____________________________________________________ Date _________________________________