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2. I am interested in the

   1. Downtown Patrol
   2. West End Patrol
4. First Name
5. Last Name
7. Date of Birth
   Date of Birth
8. Gender
   -- Select One --FemaleMale
10. Address
12. City
13. State
14. Zip Code
16. Home Phone Number
17. Work Phone Number
19. Email Address
21. Two Local References
23. First Name
24. Last Name
26. Address
28. City
29. State
30. Zip Code
32. Phone Number
34. First Name
35. Last Name
37. Address
39. City
40. State
41. Zip Code
43. Phone Number
45. As a volunteer of the Anacortes Auxiliary Patrol, I agree to abide by the following rules:
    1. While on patrol I will not carry anything that is, or resembles, a weapon including: knives, guns, mace, or pepper spray type products.
    2. I will not engage in any verbal or physical confrontations or attempt to detain or control any person(s) while on patrol.
    3. I will not patrol while under the influence of alcohol or drugs that may impair my driving and/or judgment.
    4. I will follow the directions of the on-duty Anacortes Police Department Supervisor or the Auxiliary Patrol Coordinator.
    5. I will not patrol outside of the city limits or the assigned boundaries.
    6. I will obey all laws including all traffic laws while patrolling.
    7. I will not engage in any pursuits of persons or vehicles.
    8. As a representative of the Anacortes Police Department and the Auxiliary Patrol I will carry myself in professional manner at all times.
47. E-Signature*
    I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct (RCW 9A.72.085)
49. Date & Time
    Date & Time

    Date & Time
50. Place
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52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

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