Community Policing Council Application

Contact Information

Residential Street Address   (no PO Boxes)

City, State, Zip Code  

Home Telephone Number Please include area code (e.g. 505-555-5555).

Work Telephone Number Please include area code (e.g. 505-555-5555).

Cell Telephone Number Please include area code (e.g. 505-555-5555).

Your E-Mail Address  

About You

Gender What is your gender?

Male
Female

Veteran Status Are you a veteran of the U.S. Armed Services?

Yes
No

Ethnicity Please specify your ethnicity.

White
Hispanic or Latino
Black or African American
Native American or American Indian
Asian or Pacific Islander
Mixed
Other

Disability Do you have a disability?

Yes
No

Community Information Select any community group(s) in which you participate.

Faith or Religious leader

Social services provider

Business owner

Academic advisor

Driver's License State   AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Driver's License Number  

Serving on a Community Policing Council

What experiences do you believe you bring to the table?   (600 words or fewer)

How long have you been a resident of the City of Albuquerque?  

Police Area Commands

The Albuquerque Police Department has six Area Commands:

• Foothills Area Command
• Northeast Area Command
• Northwest Area Command
• Southeast Area Command
• Southwest Area Command
• Valley Area Command

Area Command Map

Which Area Command do you live in? Use the Area Command Map to help determine which area command you live in.

Foothills Area Command
Northeast Area Command
Northwest Area Command
Southeast Area Command
Southwest Area Command
Valley Area Command

Are you currently a law enforcement officer?  

Yes
No

I fully understand that any intentional attempt on my part to provide INCORRECT or MISLEADING information would be just cause for rejection of my application.