NYPD Shomrim Application
Please insure all information is filled out for proper processing of your application.
Email address *
First Name
Middle Initial
Last name
Age
Date of Birth
MM
/
DD
/
YYYY
Gender
Uniform/Civilian
Clear selection
Rank
Clear selection
If Civilian - Title
Date of Appointment
MM
/
DD
/
YYYY
Tax#
Shield # (if applicable)
Previous Occupation (if applicable)
Mothers Maiden Name
Mothers Religion
Marital Status
Clear selection
Name of Spouse
Spouse's Religion
Spouse's Date of Birth
Spouse's Occupation
Command
Building/House #
Street
Apt#
City
State
Zipcode
Telephone#
No dashes or parenthesis please. Just the 10 digits.
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