Citizens Radio Patrol · Application

Membership application

Complete this form to apply for membership in Rosedale Park Radio Patrol #23. The Detroit Police Department reviews each application to ensure no violent offenders are admitted. We'll reach out to you directly once your application has been processed.

🔒 Is my info secure? Prefer to fill out a paper form? → Download the fillable PDF

Applicant

Name (First Middle Last)

Date of Birth

Sex

Race Required by the Detroit Police Department for all Citizens Radio Patrol applicants.

Address

Street Address

City

State

Zip Code

Phone

Home Phone

Cell Phone

Work Phone (optional)

License & Service

Driver's License Number (Michigan format: A 123 456 789 012) Required by the Detroit Police Department for a standard criminal history background check. See the Privacy Act Notice below.

How often can you serve on patrol (days/hours)

Emergency Contact

Contact Person

Telephone (Primary)

Telephone (Alternate) (optional)

Patrol

Name of Radio Patrol

President

Signature

Full Name (typed signature)

Date

Privacy Act Notice

The Detroit Police Department's application for the Citizens Radio Patrol requests your Driver's License Number. The request is made pursuant to the Department's practice of requiring program participants to provide a criminal history check using the applicant's Driver's License Number, along with any identifying information from out-of-district criminal history record checks on file with the applicant's Driver's License Number. This information is necessary for the Detroit Police Department to obtain accurate criminal history information and will be used solely for that purpose. Signing this document indicates that you have read and understood that your Driver's License Number will be used by the Detroit Police Department to obtain access to your criminal history information.

🔒 Secure form — your data is sent directly to the patrol president and forwarded to DPD — it is not stored or sold.

Is My Information Secure?

Is my information secure?

Yes. This form uses HTTPS encryption. Your submission is sent directly to the Rosedale Park Radio Patrol president and forwarded to the Detroit Police Department. It is not stored on a public server and will not be shared beyond your application.

Why do you ask for my Race?

Race is a field on the official Detroit Police Department application for the Citizens Radio Patrol. It is required by DPD — not by our patrol — and is collected solely as part of the DPD intake process.

Why do you ask for my Driver's License Number?

Your Driver's License Number is required by the Detroit Police Department to conduct a standard criminal history background check, which is required of all Citizens Radio Patrol applicants citywide. This is disclosed in the Privacy Act Notice on the official DPD form and is reproduced on this page.