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APPLICATION FOR MEMERSHIP CITIZEN PATROL AND

OMAHA COALITION OF CITIZEN PATROLS

CITIZEN PATROL________________________________________________

APLICANT’S NAME ______________________________________________

STREET ADDRESS _______________________________________________

CITY, STATE & ZIP ______________________________________________

TELEPHONE NO. ________________________________________________

DATE OF BIRTH _________________________________________________

I UNDERSTAND THAT:

    A.  The information that I have provided may be verified by conducting a criminal background check.  I hereby release and agree to hold harmless from liability any person or organization that provides information.  I also agree to hold harmless the Citizen Patrol named above, the Omaha Coalition of Citizen Patrols and the officers and volunteers thereof.

    B.  In signing this application, I have read the attached information and apply for membership in the Citizen Patrol named above.  I agree to comply with the rules and regulations adopted by both the Citizen Patrol named above and the Omaha Coalition of Citizen Patrols.  I affirm that the information I have given on this form is true and correct.

___________________________________________________     ______________________________  

Signature of Applicant                                                                       Date

OCCP/OPD JOINT JUNCTION CRITERIA

If a patroller meets one or more of the following criteria, they would not be able to participate in any future joint function:

 1.  Any felony Crime Against Person conviction.

 2.  Any felony conviction within the last five years.

 3.  Board of Mental Health committals.

 4.  Conviction for Resisting Arrest within the last ten years.

 5.  Conviction for Assault on a Peace Officer.

 6.  Two or more convictions of assault in the past five years.

 7.  Two or more convictions of DUI in the past five years.

 8.  Conviction for Carrying a Concealed Weapon within the past five years.

 9.  Currently under Court Jurisdiction.

10.  Any pending charge for a Class 1 Misdemeanor or above.

11.  Conviction of any Sex Offense.

12.  Any criminal record judged to be detrimental to the goals and objectives of the Omaha Police   

      Department.

Background Check Authorization2.pdf