Public Safety Cadets Registration

Name of Future Cadet*

Date of Birth*

Gender
—Please choose an option—MaleFemaleOther

Street Address (no P.O. Boxes)*

City*

State*

Zip/Postal Code*

Phone Number*

School*

Grade*

Parent/Guardian Information

Name of Parent/Guardian*

Street Address*

City*

State*

Zip/Postal Code*

Phone Number*

Email*

Relationship to Future Cadet*

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