Community Watch Sign Up

Personal
First Name:	A value is required.
Last Name:	A value is required.
Date of Birth:
Email:	A value is required.Invalid format.
Home Phone:	A value is required.
Work Phone:
Number of years you have lived in Saugeen Shores:

Education
Explain briefly your educational background:	characters remaining. Exceeded maximum number of characters.
Describe any training or work experiences you have had that would be beneficial to your involvment in the Commmunity Watch Program: characters remaining.Exceeded maximum number of characters.

Employment
Are you currently:
If employed, name of employer:
and employer address:
Your postion and duties:

References
Names and telephone numbers of two references (excluding family members)
Reference One:
Phone:
Refrence Two:
Phone:

General
Explain briefly why you wish to become a Community Watch Patrol member:	characters remaining. Exceeded maximum number of characters.
List associations and clubs you below to (one per line):	characters remaining. Exceeded maximum number of characters.
Have you ever been arrested for, convicted of or cited for any offense other than taffic fines of $200 or less? yes no Please make a selection.
If you answered Yes, explain in detail showing date, charges, place and action taken	characters remaining. Exceeded maximum number of characters.
Please check your information above. Once you click the SUBMIT button your information will be sent to our office.
please enter the code to the right to proceed.