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Explorer Program: POST #9258


  3. Must live in the City of Ventura

  4. (XX/XX/XXXX)

  5. (If not applicable, enter "N/A")

  6. (If not applicable, enter "N/A")

  7. (If not applicable, enter "N/A")

  8. (If not applicable, enter "N/A")

  9. (If not applicable, enter "N/A")

  10. (If not applicable, enter "N/A")

  11. (Last, First)

  12. (XXX) XXX-XXXX

  13. (Last, First)

  14. (XXX) XXX-XXXX


    In case of an emergency, please provide an emergency contact other than the parent or guardian(s) listed above.

  16. (Last, First)

  17. (XXX) XXX-XXXX

  18. (Last, First)

  19. (XXX) XXX-XXXX

  20. (If not applicable, enter "N/A")


    Please list two adult references who can comment on your suitability for our program. References can be teachers, counselors, sports coaches, employers, etc. Do not list other relatives.

  22. (Last, First)

  23. (XXX) XXX-XXXX

  24. (Last, First)

  25. (XXX) XXX-XXXX


    Please answer all of the following questions. "Yes" answers alone may not cause your application to be rejected, however, any false statements or omissions of the truth will result in disqualification from the program.

  27. Have you ever been arrested?*
  28. Have you ever received a ticket?*
  29. Have you ever had the police called on you, or had a negative police contact?*
  30. Have you ever been under the influence of alcohol?*
  31. Have you ever stolen anything?*
  32. Have you ever used or possessed any illegal drugs, including marijuana?*
  33. Have you ever been suspended from school?*
  34. Have you ever been involved in a physical fight with someone else?*
  35. Have you ever been a member of a gang, or associated with known gang members?*
  36. Have you ever committed an act of vandalism?*
  37. Have you ever been the victim of a crime?*

    I understand that any portion of this application is subject to examination by the Ventura Police Department, and/or the staff of the Ventura Explorer POST #9258. I acknowledge that all of the information contained herein will be used solely for the Explorer POST, and for no other purpose. I hereby attest that all of the information contained herein is, to the best of my knowledge, true and correct.

  39. Please check this box to acknowledge the Authorized Release stated above.*

    I hereby acknowledge that if I am selected as a member of the Ventura Police Explorer POST #9258, my primary objective will be to study the field of Law Enforcement and its possibilities for career opportunities. I acknowledge that teamwork is a necessary ingredient for the success of the POST. I will strive to achieve the objective and ideals of the POST and dedicate myself to the support of good law enforcement. I will maintain myself, both physically and mentally as an asset to the Ventura Police Department and the community.

  41. Acknowledgment of the applicant.*
  42. By entering your name here, you are acknowledging the above.

  43. Acknowledgment of the applicant's parent or guardian*
  44. By entering your name here, you are acknowledging the above.

  45. Leave This Blank:

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