Bayonet Point Middle School

Patriots on Patrol Club

Membership Application

Thank you for your interest in applying for the Patriots on Patrol Club. The purpose of the club is to allow students to explore the field of Law Enforcement and strive to maintain good values, positive character development and leadership skills. Some examples of monthly activities include:

Role of law enforcement officers

Touring the patrol vehicle

Mock Crime Scene (fingerprinting, photographing)

Importance of writing in police reports

How the Court process works

Meetings are held once a month (dates/times to be announced) at Fivay High School. The Club is led by SRO Corporal Hernandez and History Teacher Mr. V. Salso. Please complete the application below, along with the media release.

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NameStudent Number Grade

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Street Address City Zip

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Telephone Cell phone

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Email address

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Parent/Guardian Name Contact Number

Meetings/activities may be after school hours. Transportation will not be provided and will be the responsibility of the student/parent.

Requirements:

Completion of membership application including parent signatures, teacher recommendations and questionnaire.

Must maintain a 2.0 GPA.

Must not have a criminal record.

(2) Teacher Recommendation Forms completed.

I understand that being a Patriot on Patrol is a privilege. I agree to be responsible and hard working on all assigned tasks. I will be courteous and respectful to everyone who I come in contact with. If I am using a piece of school or Sheriff’s Office equipment, I will use it only for what I have been instructed to do and treat it with care. I will also keep any personal information that is seen or heard completely confidential.

I understand that if I am unable to follow this contract, I will be removed from being a Patriot on Patrol.

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Student Signature

Media Release: I do hereby authorize the District School Board of Pasco County and the Pasco Sheriff’s Office to use, in perpetuity, the participant’s likeness, voice, or performance which has been recorded on tape, film or other media. The information will be used for (1) instruction; (2) general education; or (3) entertainment purposes. Publications may include, but are not limited to: newspaper, cable television productions, videos, brochures, pamphlets, DVD, CD programs or School and district Web pages. I understand fully the conditions set forth in this document and agree to the conditions in this release.

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Student Signature Parent/Guardian Signature

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Date

Patriots on Patrol Club

Teacher Recommendation

Student:______

______I recommend the above student to be considered for the Eagle Investigators Club. Their current Grade Point Average is ______.

______I have reservations about recommending the above student for the Eagle Investigators Club.

***Please return this completed form directly to Corporal Hernandez’s mailbox in the teacher workroom.***

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Teacher Name (Print) Date

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Teacher Signature

Patriots on Patrol Club

Name:______

(Please print and return completed application to Cpl. Hernandez or Mr. Soldo, room 03-103.)

Why do you want to join the Patriots on Patrol Club?

Do you feel it is important to have strong leadership skills? Why?

What topics are you hoping to learn through the Patriots on Patrol Club?