2014 High School Police Academy Application Packet. Session 1: July 7 th 11 th Session 2: August 11 th 15 th

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1 2014 Application Packet Session 1: July 7 th 11 th Session 2: August 11 th 15 th

2 The Charlotte-Mecklenburg Police Department is offering high school students in Mecklenburg County the opportunity to experience a week at the CMPD Training Academy (1770 Shopton Road). This one-week, hands on course is designed for those young adults who are interested in a career in Law Enforcement or students who would like to find out if a career in Law Enforcement is for them. Each student will have the opportunity to learn about teambuilding, leadership, and decision-making skills that will assist them with a future career in law enforcement or can be applied to everyday life. Qualifications: Must be a resident of Mecklenburg County Must be at least 14 years of age and in the 9 th, 10 th, 11 th, or 12 th grade as of August 2014 No Arrests No out of school suspensions in the last two years Must maintain a 2.0 GPA average or better. Must be willing to participate in all activities (Academic and Physical). Cannot have attended a previous CMPD High School Academy Topics: Crime Scene Investigation Criminal Justice System and Law Impacts of Social Media Criminal Investigation Defensive Tactics Traffic Stops and Enforcement Building Searches Physical Fitness Suspect Encounters Demos from different units Responsibilities of wearing the Badge Location: Transportation: Lunch: Charlotte Mecklenburg Police Academy 1770 Shopton Road Charlotte, NC Transportation will be the responsibility of the student. Students must bring their lunch with them each day 2 of 9

3 Please make sure your application is complete before submitting. Incomplete applications may result in your rejection from the process. The Hold Harmless and Medical Release must be signed by the parent or guardian of the student in order for him or her to participate in this program. ***Application Deadline is May 30, 2014*** Please mail your Application Packet to: Charlotte Mecklenburg Police Department Attn: Officer Ryan Botzenmayer Youth Program Coordinator 601 East Trade Street Charlotte, NC If you have any additional questions or concerns please contact Officer Ryan Botzenmayer. Officer Ryan Botzenmayer Charlotte-Mecklenburg Police Department Community Services and Youth Division Youth Program Coordinator Office #: Mobile #: Address: 3 of 9

4 Last Name: First Name: Date of Birth: Race: Sex: Phone Number: T- Shirt Size: S M L XL Home Address: City: State: Zip: High School: Grade in August2014: Parent/Guardian (That you live with): Home Phone: Work Number: Emergency contact Name: Phone: Have you ever been arrested? Have you been suspended from school in the last 2 years? Have you ever used illegal drugs? Have you ever been issued a traffic citation? If Yes to any of the above questions, please explain: Do you live in Mecklenburg County? Do you have any medical conditions that would limit your participation in any of the physical activities? Yes No List any medications to be taken during the week. Applicant s Signature: Date Parent/Guardian Signature: Date Please circle the session that you prefer: 4 of 9

5 Session1: July 8 12 Session 2: August Letter of Interest Applicant s Name: There are three (3) questions to this portion of the application process that should be answered on a separate sheet by the applicant. The applicant s response must be typed and submitted with the application packet. All the questions need to be answered completely. Question # 1 What do you hope to gain by attending the? Question #2 What type of community activities do you participate in and how do you think that these activities impact our society? Question #3 Define the word RESPECT and what it means to you. No dictionaries! 5 of 9

6 Reference Sheet Applicant s Name: Dear Guidance Counselor and School Resource Officer, The above listed person has submitted an application to participate in the Charlotte- Mecklenburg Police Department Program. In order for the student to be eligible to participate they must meet the following qualifications: Must be entering 9 th, 10 th, 11 th, and 12th grade in August 2014 Must attend a High School or Home School in Mecklenburg County No major discipline problems or criminal history No out of school suspensions in the last 2 school years Must maintain a 2.0 GPA or better. Must participate in all activities. (Academic and Physical) Cannot have attended a previous CMPD High School Academy The reference form below must be filled out by the school Guidance Counselor and School Resource Officer. If your school does not have a Resource Officer then the Principal should complete that portion of the reference sheet. Guidance Counselor Guidance Counselor Name (Print): Guidance Counselor Signature: Does this applicant meet the qualifications? Yes No Comments: 6 of 9

7 School Resource Officer SRO Name: SRO Signature: Code #: SRO Does this applicant meet the qualifications? Comments: 7 of 9

8 Authorization for Medical Treatment The undersigned Parent(s) or Guardian of Hereby gives permission and authorization to the adult instructors of the Charlotte- Mecklenburg Police Department s to obtain and authorize x-rays, routine test and treatment for my son/daughter that they may deem necessary during the Charlotte-Mecklenburg Police High School Police Academy, Charlotte, North Carolina,. In the event that I/we cannot be reached in an emergency, I hereby give permission to the physician selected by the adult instructors of the High School Police Academy to hospitalize, secure proper treatment for, and to order injections and/or anesthesia and/or emergency surgery for my child named above. Parent/Guardian Name (print) Phone Parent/Guardian Signature Date Student s Name Date Alternate Emergency Contact Phone 8 of 9

9 Hold Harmless Release I, hereby give permission for my child,, to participate in the High School Academy sponsored by the Charlotte-Mecklenburg Police Department. It is my understanding that activities will take place from 7:45 am to 4:00pm. This may include but are not limited to activities such as high ropes course, group initiatives, weapons recognition, handcuffing, building searches, traffic stops and baton training. In consideration for my child s participation in this program, I hereby do forever release and agree to hold harmless the city of Charlotte and the Charlotte-Mecklenburg Police Department, its agents and employees, from any and all liability, claims and demands for personal injury resulting from my child s participation in this. I am aware of the dangers and the risks that exist from participating in the above mentioned program activities. I hereby specifically and voluntarily assume all such risks on behalf of my child and expressly release the City of Charlotte and the Charlotte- Mecklenburg Police Department and its agents and employees from any cause of action or claim of whatsoever kind or nature arising out of my child s participation in this program. Date: Name (print): Signature: Relationship: 9 of 9

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