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