Application for Citizens' Advisory Commission on Community/Police Relations
Deadline to apply: December 30, 12:00 pm (noon)

Commission's by-laws
https://drive.google.com/file/d/0Bzt8VNyslCL8LWVXUkFXYl9XY2c/view?usp=sharing
First name *
Last name *
Street address *
2500 City Hall Lane
City, State Zip Code *
North Charleston, SC 29406
Email address *
Mobile phone *
Home phone
Date of birth *
MM
/
DD
/
YYYY
Race
Gender
I represent... *
If applicable, which Council District do you represent?
If applicable, which high school do you represent?
I have read and understand this document, and by my signature, I swear that the information I have provided is true. I also understand that my signature is my authorization for the North Charleston Police Department to conduct a criminal background check on me. *
SIGN BY PRINTING NAME BELOW
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