Required fields are marked with asterisks (*)

Community Policing Volunteer Application

Volunteers are needed in West Kelowna, Peachland and Lake Country for:

Citizens Patrol
Community Policing Office
Speed Watch

The RDCO collects personal information through the Community Policing Volunteer Application for the purpose of managing applicants. Personal information is collected under the authority of sections 26(c) and 33 of the Freedom of Information and Protection of Privacy Act (FIPPA) and will be used and disclosed only as permitted by that Act.

Questions regarding the collection, use, disclosure, and protection of personal information may be directed to Privacy Officer:
Email: foi.privacy@rdco.com
Phone: 250-763-4918

By submitting an application, you hereby consent to the collection, use and disclosure of your personal data as described in this notice.

First name

Last name

Phone number

Email address

Home address:

City:

Province:

Postal code:

Date of birth (MM/dd/yyyy)

Place of birth (City, Province)

Please list all previous addresses in the past five years with dates

Driver's licence number

Province of issue

Have you ever been convicted of a criminal offence?

Yes

Employer name

Occupation

All other residents in applicant's home (exlcuding applicant)

First name

Last name

Date of birth (MM/dd/yyyy)

Place of birth (City, Province)

Drivers licence number

First name

Last name

Date of birth (MM/dd/yyyy)

Place of birth (City, Province)

Drivers licence number

First name

Last name

Date of birth (MM/dd/yyyy)

Place of birth (City, Province)

Drivers licence number

References

Full name

Address

Phone number

Full name

Address

Phone number

Document upload section

Please provide a photo of your drivers licence (front)

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Allowed extensions pdf, doc, docx, jpg, jpeg, gif, png, tif

Today's date

The RDCO employs the Community Safety Coordinator, who works with the RCMP and supports volunteers in the Community Policing program; however, the Community Policing program is administered by the RCMP.

By signing below, you confirm that you consent to the RCMP obtaining the information needed to assess your eligibility and understand that the RCMP's decision is final.

Applicant signature

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