FRESNO POLICE DEPARTMENT 

VOLUNTEER IDENTIFICATION CARD APPLICATION


Name:_____________________________________________________________________________________________
                                                 (Last)                                                                         (First)                             (Middle)

Home Address:______________________________________________________________________________________
	(Street)                                                      (City)	                                                (State)                             (Zip Code)

Home Phone:_____________________________________ Work Phone:________________________________________ 


E-mail address:______________________________________________________________________________________


Date of Birth:________________________________________________________________________________________


Height:_______________ Weight:_______________  Hair Color:__________________   Eye Color:___________________


California Drivers License Number:__________________________________________   Expires: ____________________


Volunteer Signature:______________________________________________________   Date:______________________ 



THIS SECTION TO BE COMPLETED BY THE SUPERVISOR OF THE INDIVIDUAL NAMED ABOVE

Unit or Program Assignment:________________________________________________________________________

Supervisor:__________________________________________________________  Phone:_____________________

Signature of Supervisor:_________________________________________________  Date:_____________________


FOR VIP OFFICE USE ONLY 

Card Number_______________________   Date Issued___________________  Expiration Date__________________



RETURN FORM TO VOLUNTEERS IN POLICE SERVICE (VIPS)
Fresno Police Department – Patrol Support Division
2326 Fresno Street - Fresno, California  93721