E-Gov Services Miami Township

Police Explorer Application, Post 426

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Purpose. This form serves as an application for the Miami Township Police Explorer Post #426. It provides parental permission, emergency and medical contact information, provides a release for medical treatment, provides a release for liability and notification of medical conditions.

* Information is required.

* Name

* Address

* Telephone Number

* Driver's License Number

* Father

* Father's Address (if same as applicant's - please type Same)

* Father's Telephone Number

* Father's Work Number

* Mother

* Mother's Address (if same as applicant's - please type Same)

* Mother's Telephone Number

* Mother's Work Number

* Have you ever been issued a traffic citation?

yes

If yes, please explain

* Have you ever been arrested or convicted of any criminal offense?

yes

If yes, please explain

Attach a Picture or File (max size: 30MB):

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* Information is required.

YOU ARE REQUIRED to open and read the Miami Township Police Department Directive 16.4, Auxiliary Programs. The document is linked below:

AUXILIARY PROGRAMS DIRECTIVE 16.4.

Your submission of this application indicates that YOU HAVE READ Directive 16.4, that you understand it and that you agree to comply with its provisions.

Notes:

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

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