explorers program Application

First

Last Name

Middle

Street Address

City

State

Zip

Phone Number

Date of Birth

Date of Entry

Are you eighteen (18) years of age or older?

Yes No

Do you have a Driver's License?

Yes No

Do you have a high school diploma or GED?

Yes No

Other special training or skills (language, machine operation, etc.)

Current school you are attending

Parental name, phone number and email address

Have you ever filed an application for membership into the Kenner Police Department's Explorer Program before?

Yes No

The information provided in this application is true, correct and complete. If selected into the Explorer Program, any misstatement or omission of fact on this application may result in my dismissal. If you decide to engage an investigative consumer reporting agency to report on my personal history I authorize you to do so. If a report is obtained, you must provide, at my request, the name of the agency so I may obtain from them the nature and substance of the information contained in the report.

I agree

Kenner Police Department

explorers program Application

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