| Personal Information |
|---|
| Full Name: | |
| Nickname: | |
| Street Address: | |
| City: | |
| Zip Code: | |
| Home Phone: | |
| Cell Phone: | |
| Email: | |
| Driver's License Number: | |
| Driver's License State: | |
| Age: | |
| Date of Birth: | |
| Place of Birth: | |
| Are you a U.S. Citizen or Legal Resident? If no, indicate citizenship: | |
| Hair Color: | |
| Eye Color: | |
| Height: | |
| Ethnicity: | |
| How many traffic tickets have you had in the past year? Specify types of violations: | |
| Have you ever been arrested? If yes, please explain: | |
| Do you have any physical conditions which would prevent you from perfoming the specific duties of the job? | |
| Do you have reliable transportation? | |
| Availability |
|---|
| Please indicate your general/preferred availability (e.g., any weekend, evenings, Saturdays only, etc.) | |
| Additional Information: | |
| The City of Elk Grove / Elk Grove Police Department welcomes volunteers of all backgrounds and abilities and does not discriminate on the basis of race, religion, origin, ancestry, gender, marital status, sexual orientation, age, disability, or any other classification protected by state or federal laws in its volunteer selection process. Volunteers have equal access to available positions for which they are qualified and possess the ability to do the job. |
| Skills |
|---|
| List all languages other than English which you speak, read, or write fluently: | Language: Speak: Read: Write:
Language: Speak: Read: Write:
Language: Speak: Read: Write: |
| List any skills you possess that would be an added benefit to the role of community ambassador: | |
| Volunteer Experience |
|---|
| Please list any previous volunteer experience: | Organization and Address, Dates Worked, Hours/Week, Duties
|
| Why do you want to volunteer with the Elk Grove Police Department / City of Elk Grove? | |
| What do you hope to gain from volunteering as a community ambassador: | |