To Join Wakefield Civilian Patrol

I am interested in patrolling

(Please print this page and return the entire form. Thanks.)

Mail To:
Wakefield Civilian Patrol
4354 Boyd Avenue
Bronx, New York 10466-1804
(718-324-7770)


I am interested in patrolling:

Name:___________________________________

Address:________________________________

Apt. No.:________

____________________Zip Code:___________

Telephone:(____)________________________



I am available on:

Monday __________
Tuesday __________
Wednesday __________
Thursday __________
Friday __________


I want to be a:

Driver _______
Rider _______
Base Operator _______