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Hopkins Police Department Volunteer Application
Release of Information
The City of Hopkins requires a check of the criminal history for all persons volunteering in the Police Department. You may refuse to authorize the release of this information, but a failure to do so will result in disqualification as a Hopkins Police Volunteer.

I authorize the City of Hopkins to obtain, and the State of Minnesota to release, all information in the State of Minnesota Criminal Justice Information System regarding the undersigned. I hereby release the City of Hopkins and the State of Minnesota from any claims or damages which I might have as a result of the City obtaining this information from the state. This authorization is effective for three months following the date of execution.

This information is being requested by the City to determine if I meet the minimum requirements or are otherwise disqualified from volunteering with the Police Department Volunteer Program.

This information is classified as private personnel data and will be provided only to those City employees or agents who have a need to review it. The City does not intend to release the information to any other party but may be required to do so by subpoena or court order under the provisions of Minnesota Statute, Chapter 13.
Full Name*
Date of Birth*
Date of Birth
Electronic Signature*
Today's Date*
Today's Date
Personal Information
First Name*
Middle Name*
Last Name*
Present Permanent Address*
City*
State*
Zip Code*
Date you began living at this address*
Date you began living at this address
Phone Number*
Email Address*
Are you under the age of 18?*
1. Yes
2. No
Parent/Guardian First Name*
Parent/Guardian Last Name*
Address*
City*
State*
Zip Code*
Phone Number*
Email Address*
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Page 2

Criminal History
Have you ever been arrested or charged with a crime?*
1. Yes
2. No
If yes, indicate the charge and disposition of the case. Include traffic citations.
Interests and Goals
What skills and abilities could you bring to the volunteer unit (data entry, computer skills, community outreach, etc)?*
Please discuss why you would like to become a Hopkins Police Department volunteer?*
Please discuss your future law enforcement goals. You DO NOT need to be entering the law enforcement field to volunteer.*
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Page 3

Employment/Education Information
Present/Most Recent Employment/Education
Employer/School
Address
Your Title/Grade or Year
Specific Duties/Major
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Page 4

References
Name of Reference # 1
Address
Phone Number
Email
Relationship
Name of Reference #2
Address
Phone Number
Email
Relationship
Name of Reference #3
Address
Phone Number
Email
Relationship
If you have a resume or cover letter, feel free to upload it here.
Certification
I hereby certify that all statements made in this application are true and complete to the best of my knowledge and ability, and I realize that any misstatement or omissions of material facts may subject me to disqualification, dismissal, or possible criminal prosecution.
Electronic Signature*
Date
Date

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1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Police Department Volunteer Application

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