Winter Garden Police Explorer Post 901
Application
Name
Date of Birth
Race Gender
Address
City State Zip
Home Phone # Cell Phone #
Email Address
School Grade
Parent/Guardian
Work Phone # Cell Phone #
Please answer all following questions.
Have you ever been suspended or expelled from school? If yes, when and why?
Have you ever been arrested? If yes, when and why? Please include Notice to Appear.
Do you have any current or past medical or psychological history that could prohibit you
from participating in high liability activities (defensive tactics, overnight camping trips,
etc)? If yes, please explain.
How did you hear about Winter Garden Police Explorer Post 901?
Why do you want to be an Explorer?
What are your current career goals?
What areas of Law Enforcement interest you?
What do you expect to gain from being a Police Explorer?
What other extra-curricular activities are you involved with?
What are your hobbies?
What does the word “Integrity” means to you?
Please list a reference (not related to applicant) that we may contact to ask about
your character, experience, personality and other qualities.
Name
Relationship to applicant
Phone
Email
Emergency Contact Information:
Name
Relationship to applicant
Phone
Email
I understand that by submitting this I am granting the Winter Garden
Police Department and the Winter Garden Police Explorer Post 901 to
conduct a background check on the applicant. I affirm that this
application contains no misrepresentations, falsifications, omissions
or concealment of fact. The information given by me is true and
complete. I am aware that falsification will be grounds for INSTANT
disqualifications and termination from the Winter Garden Police
Explorer Post 901.
Applicant Signature _______________________________
Parent/Guardian Signature ______________________________
Date Submitted ______________________________