Ride-Along Program Application

This form is to request permission to ride as a citizen observer with an officer of the Lake Oswego Police Department. Please complete page two of the attached PDF form and bring it with you. If preferred, you may download and submit the form via email at police-info@lakeoswego.city, in person, or via fax to (503) 675-3744 to our ride-along coordinator.

Online Application

* Required fields

Personal Information

Full Name *

Last Name, First, Middle

Maiden/Other Names

Street Address *

City *

State *

Zip *

Email Address *

Phone Number *

format: 503-555-9999

Date of Birth *

Month

Day

Year

Driver's License Number *

Driver's License State *

Additional Details

I hereby request permission** to ride as a citizen observer with an officer of the Lake Oswego Police Department because:

Detailed Response *

** All applications are subject to approval

Have you ever been arrested? *

Yes

If yes, please explain

Reservation Details

Listed below are my preferred dates and hours for a ride-along. These dates are at least 21 days from the date when my application is submitted to allow for scheduling. Allow a four hour block of time for the ride-along.

Day shift: 6:00 am to 4:00 pm

Swing shift: 2:00 pm to midnight

Graveyard shift: 8:00 pm to 6:00 am

1st Preferred Date *

Month

Day

Year

1st Preferred Time *

Hour

Minute

2nd Preferred Date *

Month

Day

Year

2nd Preferred Time *

Hour

Minute

3rd Preferred Date *

Month

Day

Year

3rd Preferred Time *

Hour

Minute

Release Agreement *

I further agree with and voluntarily sign the Release and Hold Harmless Agreement (see attachment).

Attachments

Other Materials:

PDF Application Download

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Ride-Along Program Application

Online Application