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Welcome to the City of Mt. Juliet, TN, Action Line

Today is Saturday, November 21, 2009.
Police Explorers Application

Purpose. This form is used to apply for the MJPD Police Explorers program.

* Information is required.

Contact Information

* First Name:
* Last Name:
Email:
* Daytime Phone: ()  –
* Address:
* City:
* State:
* ZIP:

* Parent's Name
 
* Parent's Phone Number
 
* Driver's License Number
 
* State of Driver's License Issuance
 
* School Attending
 
* Grade Level
 
* Have you ever had any contact with the police or been arrested?
Yes
No
 
If yes, explain
 
* Is any member of the family affiliated with a law enforcement agency?
Yes
No
 
Name
 
Agency
 
Assignment
 
Contact Phone Number
 
* Why do you want to be a member of Explorer Post #465?
 
* Do you intend to seek a vocation in a law enforcement related field?
Yes
No
 
If yes, state the type of agency or field
 
* Why do you seek employment in that particular field?
 
* What other organizations/activities are you involved in or a part of?
 
* Are you currently employed?
Full Time
Part Time
Not Currently Employed
 
Business
 
Duties you perform
 
* Have you ever participated in previous exploring activities?
Yes
No
 
If yes, Explorer Post
 
Title
 
Location
 
Check here to have email confirmation of this request sent.

* Information is required.

Notes:

If you send us a message, you'll receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Information we receive may be considered public information which is subject to disclosure under current state law. Learn more about our Privacy Policy.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.

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