Dog Walker Watch Application

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Please correct the fields below:

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

Your Name:

First:

Middle:

Last:

What neighborhood or apartment community do you live in?

Sex (as listed on your TXDL or TXID)

Other Names Used:

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

*

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

Texas DL or ID Number:

Home Address:

Home Phone:

Work Phone:

Email Address (For contact by our Crime Prevention Officers):

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 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