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Public Safety Cadet Application

Name *

First

Middle

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Home
Cell

Email *

Date of Birth *

Sex: *

Male
Female

Race:

Hispanic
American Indian
African American
Asian
White

Emergency Contact *

First

Last

Relationship to you? *

Father/Mother/Guardian

Emergency Contact Phone Number *

Emergency Contact Email *

Please Upload a picture of your Driver's License, State ID and/or Passport

Drag & Drop Files, Choose Files to Upload

Name of School:

Employer:

Occupation:

Employer's Address:

Address Line 1

Address Line 2

City

State

Zip Code

Work Hours:

If Unemployed, Last Employer:

May we discuss your present/past employer or school?

yes
no

Do you have Facebook? *

yes
no

If yes, Username:

Have you ever been arrested, detained, or taken into custody ANYWHERE? *

yes
no

If you answered yes, please explain:

Please include the date, location, charge and disposition.

Do you have any Physical or Mental Disorders now or in the past? *

yes
no

If you answered yes, please explain:

Please include the date, location, charge and disposition.

Do you have any distinguishing marks, tattoos or scars? *

yes
no

If you answered yes, please explain:

Please include the date, location, charge and disposition.

Tell us why you would like to become a Milwaukee Police Department Public Safety Cadet. *

References:

Please provide contact information for two references, who are not related to you and can speak to your character.

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

Please check to indicate you agree:

I hereby acknowledge my complete understanding that the standby law enforcement assignment I am volunteering for carries with it the requirement that I will, without questions, obey and execute to the best of my ability the legal orders or those designated to supervise and commend my activities: that I am to complete all training courses; and that any Violation or disregard of the Rules and Regulations of my organization will be cause for disciplinary action or dismissal. Furthermore, I understand that any false statements intentionally made in my application disqualifies me for membership In the Milwaukee Police Department Public Safety Cadets.

Name: *

First

Last

Date: *

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