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Citizens on Patrol Application

  1. Citizens on Patrol logo.jpg

  2. If a field is marked *, it is required. If a field is not applicable, please type N/A in the field.

  3. Are you presently employed?*

  4. Full-Time or Part-Time?

  5. Have you ever been arrested?*

  6. Have you ever been convicted of any offense other than minor traffic citations?*

  7. Have you ever been the victim of a crime?*

  8. Was this crime reported to the police?

  9. I hereby certify by my signature that the information contained herein is truthful and there are no willful misrepresentations or falsifications in this application, and all answers are true and correct to the best of my knowledge.

    I hereby authorize the City of Sterling Heights to make a thorough investigation of my past employment, driving record, criminal conviction records, and educational attainment. I agree to cooperate in such investigation and I release the City and any person or organization supplying information to the City in connection with such investigation of and from liability in connection with the furnishing or use of such information.

  10. Leave This Blank:

  11. This field is not part of the form submission.