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RIDE-ALONG APPLICATION
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[b]PERSONAL INFORMATION[/b]
First name: Statham
Middle name(s): -
Last name: Dan
Date of birth: 10/29/1989
Address: Blueberry Avenue #2
Phone number: 746954

[b]MOTIVATION[/b]
What is the reason you applied for a ride-along?
I would like to pursue into getting more information and find out more about this job.

[b]STATEMENT[/b]
I, below signed applicant, hereby authorize the Los Santos Police Department to conduct a thorough investigation of my past records, including but not limited to my medical records, educational records, work records and any other inquiries that can be considered as justified in regards to my application for the ride-along. I release the Los Santos Police Department from any legal claims, demands or liabilities that may be caused as a direct result by said inquiries.

I certify that all answers above are truthful and accurate to the best of my knowledge and that I am not withholding any information that could be deemed as important. I promise that I have filled out my application on my own, without the help of any third party. I agree to maintain any correspondence between the Los Santos Police Department and myself as private and that I will not disclose any information or material to a third party.

I hereby declare that I am aware of the dangers and hazards of participating in a ride-along and I will not make the Los Santos Police Department accountable for any injuries, damages to my personal property or any mental disturbance caused by the events that I came across in the ride-along.

I acknowledge that the relationship between myself and the Los Santos Police Department is strictly of an "at will" nature, and that I may be denied from the ride-along process for any reasons that the employer deems as justified. I also understand that in certain events, the reasons for my rejection may remain further undisclosed.

[RIGHT]Date,
2/10/2016
Signed,
Dan Statham[/RIGHT][/divbox]