Fillable Internship Program Application Police Department Internship Program Application

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Internship Program Application Police Department Internship Program Application

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Coppin State University Police Department Internship Program
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Email
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DateofBirth Driver’sLicense#
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StudentI.D#
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SocialSecurity#
WorkExperience
Current/PreviousEmployer
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WorkPhone
JobTitle Supervisor
PriorVolunteerExperience:
Hobbies,PersonalInterests:
SpecialSkills&Trainin g
LanguageSpoken(otherthanEnglish)
HighSchoolGraduate
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College
Graduate
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YesNo
CollegeMajor
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(Please note that any person with any Felony conviction, any Domestic Violence conviction or
any person currently on Probation will automatically disqualify from this position.)
Have you ever been arrested, convicted, and/or placed on probation for any criminal offense as a
juvenile or adult?
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If you checked Yes, you will not automatically be disqualified, but you are required to provide
the following information:
Offense:
Arrest Date: Convicted:
Yes No
Offense:
Arrest Date: Convicted:
Yes No
Emergency Contact Information
Name
Address
Home Phone Cell Phone Relationship
If you are applying for an internship, please complete the following:
How many intern hours must complete?
Intern Start Date? Intern Completion Date?
Program or College: Instructor or Intern Administrator’s Name:
Phone Number:
Special projects or assignment required to complete Internship:
The CSUPD Internship Program is under no obligation to accept all interested Volunteers
The requirements for this position include:
• Must be 18 years or older
• Must pass an extensive Background Investigation
• Must perform specific duties
• Must work within a police facility, or work for a police unit.
• Work according to a set schedule (minimum 12 hours per month)
• Be evaluated and supervised by Department personnel
• Fulltime college student enrolled in an internship program.
I certify that all statements made in this application are true and authorization is given to
investigate all matters contained therein. Any false Statement or intentional misrepresentation
will be cause for disqualification or immediate dismissal from the VOLT Program at any time
during the period of my placement.
Signature of Applicant: ______________________ Date: _____________________________
Office (410) 951-3755 FAX (410) 951-2584
Completed application should be returned or mailed to:
Coppin State University Police Internship Program 2500 W. North Ave, Physical
Education Complex room 272, Baltimore, MD 21239
Applications may also be emailed to aboddie@coppin.edu.
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Coppin State University Police Department Internship Program
Intern Program Mission
Statement
It is the mission of the Coppin State University Police Intern Program to educate and
involve
students in police
operations, to interest them in possible law enforcement careers, to build
mutual
understanding between the
student's
population and the police department, and to develop h1terns as
well-
rounded, law abiding individuals. The education
aspect provides knowledge of law enforcement or
not.
The
Intern Program offers the exposure and training necessary to
facilitate successful entry into the
law
enforcement profession; furthermore, Law Enforcement Interning seeks to instill a
desire in its
members
to demonstrate law abiding habits, attitudes and practices as contributing citizens of our
community.
Entry into the
Program
Individuals desiring entry into the Coppin State University Police Intern Program will submit
an official
application and will be required to go through a criminal history and background investigation.
In
addition, each new
Intern must participate in a selection process which may include, but is not limited
to,
an oral interview, reference check,
criminal background investigation, and a meeting with the
Intern
Coordinator and/or other members of the Coppin State
University Police Department. Any Intern with Criminal convictions before/ after entry into the program will be grounds for
dismissal. Other
criminal-
activities, without conviction, before or after entry into the program, may also be grounds for
dismissal,
and will be judged on a case-by-case
basis.
Once the application is received, and the necessary test and application process is completed,
applicants'
names will be
placed on a hiring list in order of their eligibility. Future hiring will be done in order off
of
that
list.
In order for a student to be admitted into, and to retain membership in the Coppin State University
Police
Department
Internship Program, they must be enrolled as a full-time student at Coppin State
University
and must be able to maintain a
2.5 GPA. Interns will, at all times, conduct themselves appropriately
as
representatives of the law enforcement
community. They will practice good moral judgment and
skills and
will present themselves in a professional
manner.
Interns accepted into the program will be provided with an overview of the Coppin State
University
Police Department
which will include a tour of the Physical Education Complex (PEC) Building
and
introduction to appropriate division
personnel.
Intern Program
Duties
A Police Intern is a college student working as a non-paid volunteer for the Coppin
State
University Police
Department. Interns will work with commissioned police professionals who
will
provide supervision, training, and
direction. Interns perform their duties under the general authority of
the
Public Safety Director at the Coppin State
University Police
Department.
The Intern is a support person without regular police arrest powers. Duties may include
functions
normally assigned to an
officer, except the responsibility for general authority to arrest criminal
offenders.
Duties normally assigned included
traffic directions, crowd control, security at crime scenes,
or
investigation. Interns may also participate in foot patrol, and
may also accompany a commissioned
law
enforcement officer, on patrol
ride-along.
Although interns are not used in place of law enforcement personnel, they can supplement them.
Interns
can free officers
so that they can concentrate on the most important aspect of their jobs. Utilizing
interns
to their full potential can bring
savings in staffing levels within the
department.
Intern Ride-Along
Program
Interns have the opportunity to participate in a Ride-Along Program sponsored by the
Coppin
State University
Police Department. The Ride-Along Program provides the intern with the opportunity
to
observe the officers as they work
in the field and gain hands on
experience.
To participate in-the-Ride-Along-Program,
each intern must-complete a Police Ride-Along
Program
Request form and
Wavier to the
Ride-Along.
Coppin State University Police Department Internship Program
POLICE RIDE-A-LONG PROGRAM REQUEST FORM AND
WAIVER
I, the
undersigned,
hereby
have voluntarily elected to ride as a passenger
in
a
Departmental vehicle
of the Coppin State University Police
Department, a t such times and in
such areas as may be approved by the Chief of Police or his
designated
representative. I understand that
the police vehicle will be engaged in normal police patrol and law
enforcement
activities, some of
which may be dangerous and expose passengers to risk or harm. I acknowledge this risk of
harm
and
voluntarily accept it, hereby releasing the Coppin State University, the Coppin State University Police
Department,
the
individual officers and employees of the Coppin State University from any liability
which might result from
my
Participation in this program. I give permission to have my background
checked for criminal history.
WHEREAS, the undersigned desires to do so at his own risk and recognizing the possible and inherent
danger to his person and property resulting therefrom; and
WHEREAS, the Coppin State University and the State of Maryland does not wish to be liable for any
damages arising from personal injuries and/or property damage sustained;
NOW, THERFORE in consideration of the premises and other good and valuable consideration, the
undersigned does hereby, for himself (or herself), his wife, (or husband), heirs, executor or administrator, and
personal representatives:
I, assume full responsibility for any personal injury or damage to his person or property which may occur,
directly, or indirectly, while in, on or about any such Police Department vehicle, the Police Department
premises or any part thereof at the Coppin State University Police Department Headquarters Building or the
Baltimore City Courthouse, or at any of the several District station houses of the Baltimore Police
Department, or while accompanying any Coppin State University Police Officer in the performance of their
duties.
2. Fully and forever release and discharge Coppin State University and the State of Maryland, its agents and
employees, from any and all claims, demands, damages rights of action, or causes of action, present or
future, whether the same be known, anticipated or un- anticipated, resulting from or arising out of the
undersigned's being in, on or about any such Police Department vehicle, or at any or all of the premises and
places aforesaid, or while accompanying any police officers of Coppin State University aforesaid:
3. Indemnify and hold harmless the Coppin State University and the State of Maryland, its agents and
employees, for any acts or conduct of the undersigned of whatever kind or nature Whatsoever, while in, on or
about any such Police Department Vehicle, or at any or all of the premises and places aforesaid, or while
accompanying any such police officer as aforesaid;
4. Agree to defend and to pay any costs or attorney's fees as a result of any action brought by or against
Coppin State University or the State of Maryland, its agents and employees, for any acts or conduct of the
undersigned of whatever kind or nature whatsoever, while in, on or about any such Police Department
vehicles, or at any or all of the premises and places aforesaid, or while accompanying any such police
officer as aforesaid; and
5. Agree that it is the intent of the undersigned that this Release and Indemnity Agreement be in full force
and effect at any time after the execution hereof.
Signature of
Applicant:
Date:
NOTE: Applicants under eighteen (18) years of age must have this form read and signed by their parent or
guardian
prior to any participation in this program. The ride-along program is generally open to persons in the
Internship
program
or students by request only.
PERMISSION OF PARENT OR
GUARDIAN
I, the undersigned, being the parent or guardian of _ hereby join with him/her in requesting
permission for him/her to ride in a police vehicle as aforesaid and do join with him/her in granting a release and discharge
to the Coppin State University, the Coppin State University Police Department, the individual officers and employees of
the Coppin State University, as set out in detail above.
Signature of Parent or
Guardian: _________________
Date: _____________________
In case of emergency
notify:
____________________
Phone:
PLEASE PRINT THE FOLLOWING REQUIRED
INFORMATION
________________________
Full Name of Applicant: ___________________
Phone
Number:
Address: ______________________________________________
Email
Address:
Driver's License/I.D. Card #: Date of Birth:
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Coppin State University Police Department Internship Program
Ride-Along Rules
&
Regulations
1. No person shall be allowed to ride without having submitted a signed ride-along request and
waiver form. Refusal to complete this form, or false statements of any nature on same, will
disqualify that person from participation in the program. The request to ride form must be
turned in to the Police Department prior to the first requested
date of participation.
2. Civilian ride-along will be allowed to ride no more than once every six months, without
prior
approval of the patrol commander.
3. Participants must obey the orders and
instructions
given by the officer to whom they are assigned.
4. Participants must not leave the patrol
vehicle
unless instructed to do so by the officer.
5. When the patrol unit is assigned to a dangerous call, the rider may be dropped off at a safe
location and he/she must remain there until the officer or another police unit returns to pick
him/her up.
6. The rider will provide his/her own
transportation
to and from the Police Department.
7.
Background c
hecks will be conducted on all applicants.
8. Ride along tours usually last four (4) hour; however, either the officer
or the
rider may terminate
the tour at any time. The
Sergeant/OlC
will be advised of early termination.
9. Applicants will be notified by the Police Department after filing the written application request
form. At that time, the ride will be scheduled and/or confirmed, or denied.
10. The applicant's participation is a privilege and not a right. The basic premise of the ride along
program is to establish rapport with the police and learn about the functions of law enforcement.
11. Participants shall not converse with any prisoners, suspects, victims or witnesses nor shall
they participate in any police activity unless directly requested by officers.
12. All participants must agree not to discuss names of persons involved in police cases or incidents.
The observer will be considered a confidant of the Police Department and it is essential that
all matters pertaining to evidence or statements gathered in investigations be held confidential.
13. Tape recorders and cameras will not be permitted while participating in the program,
unless express permission is granted by the Operations Lieutenant
.
14. By signing the waiver for the ride along participant agrees to the rules and regulations listed
above.
Coppin State University Police Department Internship Program
AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION
I, ____________________________________ do herby, authorize a review of and full disclosure of all
records, or any part thereof, concerning myself, by a duly authorized agent of the Coppin State University
Police Department, whether the said records are of public, private, or confidential nature, and regardless of
whether the information released may be derogatory in nature.
The intent of this authorization is to give my consent for full and complete disclosure of the records of
educational institutions; financial credit institutions, including records of deposits, withdrawals and balances of
checking and savings account s, and loans; and also the records of commercial or retail credit agencies
(including credit reports and/or ratings); medical and psychiatric treatment and/or consultation, including
hospitals, clinics, private practitioners, and the U.S. veterans Administration; public utility companies;
employment and pre-employment records, including background reports and polygraph examination results,
efficiency rating, complaints or grievances filed by or against me, and salary records; real and personal
property records, other financial grievances, statements and records wherever filed; records of complaint,
arrest, trial and/or complaints of a civil nature made by or against, whosesoever located, and to include the
records and recollections of attorneys at law, or of other counsel, whether representing me or another person in
any case in which I presently have, or have had an interest.
I reiterate, and emphasize that the intent of this authorization is to provide full and free access to the
background and history of my personal life, for the specific purpose of pursuing a background investigation
that may provide pertinent data for the Coppin State Police Department to consider in determining my
suitability for employment by that department. It is my specific intent to provide access to personal
information, however personal or confidential it may appear to be, and the sources of information of
information specifically identified herein.
I understand that any information obtained by personal history background investigation that is
developed directly or indirectly, I whole or in part, upon this release authorization will be considered in
determining my suitability for employment by the Coppin State University Police Department.
I agree to indemnify and hold harmless the person who this request is presented and his agents and
employees, from and against all claims, damages, losses and expenses, including reasonable attorneys’ fees
arising out of or by reason of complying with this request.
I further understand that in the event my application is disapproved, the source of confidential
information cannot be revealed to me. A photocopy of this release form will be valid as an original hereof,
even though the said photocopy does not contain an original writing of my signature.
Signature: ___________________________________ Date: ____________________________
Address: ___________________________________________ D.O.B: __________________________
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Internship Program Application Police Department Internship Program Application

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Completed 3 December 2019

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