CWP Application

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Please correct the fields below:

Please correct the field(s) marked in red below:

Please enter the name of your Crime Watch Patrol or Neighborhood:

Your Name:

First:

Middle:

Last:

Race (as listed on your TXDL or TXID)

Sex (as listed on your TXDL or TXID)

Other Names Used:

Date of Birth (format is MM/DD/YYYY):

Texas DL or ID Number:

Home Address:

Home Phone:

Work Phone:

Email Address (For CWP alerts/information):

Emergency Contact

Contact's Name:

Contact's Address:

Contact's Phone:

References

1st Reference Name:

1st Reference Address:

1st Reference Phone:

2nd Reference Name:

2nd Reference Address:

2nd Reference Phone:

Have you been arrested?

Yes

If you answered "Yes" to being arrested, please provide a short explanation:

What other states have you lived in?

BY SUBMITTING THIS APPLICATION, YOU CERTIFY THAT YOU UNDERSTAND AND GIVE YOUR FULL CONSENT TO THE RICHARDSON POLICE DEPARTMENT TO CONDUCT A CRIMINAL HISTORY CHECK. YOU FURTHER UNDERSTAND THAT YOUR CHARACTER REFERENCES MAY ALSO BE CHECKED. (THIS INFORMATION WILL BE KEPT CONFIDENTIAL AND IS NOT RELEASABLE TO THE PUBLIC.) YOU ALSO UNDERSTAND THAT THE RICHARDSON POLICE DEPARTMENT WILL NOT HAVE TO DISCLOSE THE REASON, IF ANY, FOR NOT BEING ACCEPTED TO THE PROGRAM.

To receive a copy of your submission, please fill out your email address below and submit.
Email Address