NYPD Volunteer Auxiliary Police Application – Education For All Communities

Do you describe yourself as: *

(You must be a U.S. citizen, lawful permanent resident, or authorized to work in the United States)

First Name *

Middle Name

Last Name *

Address *

Address

Apt/Flr/Ste

City

State / Province / Region

Zip / Postal Code

Place of Birth *

(US State or Country if born outside USA)

Cell Phone *

Home Phone

Email *

Resident Precinct *

Select the precinct close to your address (type on Google search "precinct near me")

First Name *

Last Name *

Phone *

Relationship to Auxiliary Member *

Employement status *

Employement Information

Company/Employer Name

Type of business

Job Title

Address

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Employer Phone#

Supervisor Name

How many year employed by this company?

Edcation status?

Name High School Attended

Name

City High School Attended

State High School Attended

Zip / Postal Code

Country

Name the college attended

Name

College Attended

College address

Zip / Postal Code

Country

Degree

Did you serve in army?

Military Branch Served/Serving

Current Status

Type of Discharge (If Applicable)

Do you own a pistol/rifle/shotgun?

Pistol/Rifle/Shotgun License#

License Type

Status

Do you currently have any physical or mental conditions that would interfere with your ability to perform Auxiliary Police duties?

Tell us more

Are you currently using illegal drugs?

Which drugs?

Have you ever been member or applied for the Auxiliary Police Program?

Approximately what year did you apply and/or what precinct did you volunteer in?

Have you been involved in any incidents (including summonses which were returnable to a criminal court) which resulted in a conviction? (include yourthful offender adjudications and convictions which have been sealed pursant to CPL 160.55 and 160.59)

Tell us more about the incidents

Do you have any criminal actions that are still pending?

Tell us more about the criminal actions in pending

Have you ever applied to New York City Police Department for employement?

Indicate exam # and list # right here.

ACKNOWLEDGMENT OF N.Y.P.D. DRUG POLICY STATEMENT *

The New York City Police Department is a law enforcement agency and as such, the department has a zero-tolerance policy concerning the use or possession of illegal drugs. Any member or applicant of the Auxiliary Police Program found in possession of illegal drugs or drug paraphernalia will be terminated from the program. Furthermore, any member or applicant under the influence of illegal drugs who tests positive for illegal drugs will also be terminated from the program. In addition, any member or applicant who refuses to take a drug screening test when ordered to do so because of reasonable suspicion of drug use, or is scheduled under the random pre-enrollment guide, or similar type testing program, will be terminated. The New York City Police Department will not tolerate the use or possession of illegal drugs.

Privacy Policy *

ANY PERSON KNOWINGLY MAKING A FALSE WRITTEN STATEMENT SHALL BE LIABLE TO PUNISHMENT FOR A CLASS “A” MISDEMEANOR UNDER SECTION 210.45 OF THE NEW YORK STATE PENAL LAW.

APPLICANTS DRUG POLICY STATEMENT *

As a condition of my participation in the Auxiliary Police Program or in the application process, I acknowledge that I have been advised of this zero-tolerance policy and I agree that I am subject to the terms described above. I have been appraised of the duties for which I am volunteering and realize that I must be in good physical condition to participate in the program. I do hereby certify that to the best of my knowledge, I am in good physical health and suffer no medical disabilities which would disqualify me from participation in the New York City Auxiliary Police Program. I do hereby agree, that if such medical disability becomes known to me at some future date, I will immediately make the information learned, known to the Auxiliary Police Section in writing. All of the information entered on this form is true to the best of my knowledge.

MEDICAL CERTIFICATION *

Applicants for the Auxiliary Police Program are required to be physically capable of performing the essential functions of the position of Auxiliary Police Officer, including, but not limited to, patrol duties. Patrol duties include wearing a uniform with an equipment belt and a bullet-resistant vest weighing (10) ten to (15) fifteen pounds. Auxiliary Police Officers also perform foot post which includes standing and walking for approximately (3) three hours or more. Certain foot posts include traffic and pedestrian control for an extended period of time in all types of weather and environmental conditions. In addition to the initial self-defense training, all Auxiliary Police members must pass a yearly self-defense refresher which requires them to perform the following maneuvers:  Demonstrate various strikes (punches) and kicks repeatedly on an impact pad  Demonstrate blocking maneuvers  Handcuff an individual  Swing a police baton repeatedly with force  Demonstrate how to escape from various choke holds The Auxiliary Officer has to possess physical balance, hand strength, and flexibility in order to accomplish all of these maneuvers. Auxiliary Police also serves as the “ EYES and EARS” for the Police Department. Therefore, it is necessary that participants be able to:  Remain alert and observant of any suspicious or out-of-the-ordinary situations  Be able to visually inspect the post they are assigned to  Maintain visual observations of dangerous incidents or crimes in progress and report back to police personnel  Be able to hear and transmit instructions over a police radio including times when background noise is present You can assist the N.Y.P.D. in its effort to ensure that our applicants / current members are physically capable of performing the essential functions of the position of Auxiliary Police Officer. All the information obtained in the medical inquiry will be treated as confidential.

Upload (ID, Permit, Licesne) both sides *

Drop your file here or click here to upload You can upload up to 2 files.

Upload Social Security Card (Both sides) *

Drop your file here or click here to upload You can upload up to 2 files.

Upload Proof of address *

Drop your file here or click here to upload

Support our cause *