Mukwonago Police Explorer Post #429 Application Dear Parent/Guardian: Your son/daughter has expressed interest in becoming a member of the Mukwonago Police Department Explorer Post# 429. We are always eager to accept new members, as we feel this is a unique opportunity for young people. Law enforcement exploring is an opportunity for young people ages fifteen to twenty-one to learn about the challenging field of law enforcement. Explorers currently attend one monthly meeting, at which various topics are discussed, and enjoy limited hands-on type training activities. Members of the explorer post are given the opportunity to work different community functions throughout the Village of Mukwonago with our regular officers. These would include functions such as traffic control at parades, talks by police officers, and tours of local police departments. It is important for you as a parent/guardian to be fully aware of this part of the program. Your son/daughter requires your notarized signature for consent to participate in this program. lf you have any questions, please feel free to cont.act Officer Cory Kirkpatrick (12:00a.m. - 8:00 a.m.) or Officer Chris DeMotto (8:00 a.m. - 4:00 p.m.) at 262-363-6435. They will try to answer your questions. Sincerely, Kevin Schmidt Chief of Police Mukwonago Police Department Date Date Format: MM slash DD slash YYYY Applicant Name First Middle Initial Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth Date Format: MM slash DD slash YYYY PhoneSchool You AttendGradeParent/Guardian Name First Last PhoneParent/Guardian Name First Last PhoneContact Email Emergency Contact InformationEmergency Contact #1 First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneMobile PhoneRelationship to ExplorerEmergency Contact #2 First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneMobile PhoneRelationship to ExplorerI, as the applicant's parent/guardian, give consent for my son/daughter to participate in all activities of the Mukwonago Law Enforcement Post # 429 program. 1 understand that I am giving consent for my child to participate in community activities, and that there is the potential for danger with such activities. Parent/Guardian Name First Last Signature
