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Home > Neighborhood Watch Area Coordinator Application

Neighborhood Watch Area Coordinator Application

ADA COUNTY SHERIFF’S OFFICE
Neighborhood Watch
Area Coordinator Application

Name of Subdivision(Required)

Name(Required)

First Middle Last

Other Names Used

Date of Birth(Required)

MM slash DD slash YYYY

Place of Birth

Driver's License/ID Number(Required)

*Please include a copy of your Driver's License or ID with application.

Driver's License or ID

Max. file size: 10 MB.

Gender

Female

Male

Race

Height

Weight

Hair Color

Eye Color

Home Number

Work Number

Cellular Number

Email(Required)

Current Mailing Address(Required)

Street Address City State ZIP Code

How long at this address(Required)

Other States resided in

List all other addresses below where you have lived in the past five (5) years

1. Address

Street Address City State ZIP Code

2. Address

Street Address City State ZIP Code

3. Address

Street Address City State ZIP Code

4. Address

Street Address City State ZIP Code

5. Address

Street Address City State ZIP Code

Have you used illegal drugs within the past five years?(Required)

Yes

No

If yes, explain

Are you a U.S. citizen?(Required)

Yes

No

If no, what is residence/visa status?

Have you ever been arrested/detained by the police?(Required)

Yes

No

If yes, please state when and why?

Are you currently on felony, misdemeanor or unsupervised probation?(Required)

Yes

No

Have you ever been fingerprinted by a police agency other than for an arrest?(Required)

Yes

No

If yes, please state the date, agency, and purpose?

Why do you want to be a Neighborhood Watch Leader?

Emergency Contact

Name

Phone

Relationship

References: Please list three persons whom we may contact. Do not include anyone related to you.

1. Name

1. Phone

2. Name

2. Phone

3. Name

3. Phone

I certify that the information provided by me in this application is true and complete to the best of my knowledge. You are hereby authorized to conduct an investigation of my personal history including matters of a privileged or confidential nature, and I hereby release you from liability or damage, which may result from such release and investigation.

Signature of Applicant

Date

MM slash DD slash YYYY

ADA COUNTY SHERIFF’S OFFICE
COMMUNITY ENGAGEMENT & INFORMATION
7200 BARRISTER DR.
BOISE, ID 83704
If you have any questions, please contact
ACSO Community Outreach Coordinator
(208) 577-3775 or [email protected]

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Ada County Sheriff’s Office

7200 Barrister Dr.
Boise, ID 83704

208 577 3000 (Primary)
208 377 6790 (Non-Emergency Dispatch)

Dial 911 for emergencies only

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200 W Front St,
Boise, ID 83702
Phone: 208 287-7080

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