2. PORT ANGELES POLICE DEPARTMENT PENCOM 
   321 East 5th Street Port Angeles, WA 98362 360-417-4970 

   Dispatch Sit-Along Program 
   PenCom, the Communications Division of the Port Angeles Police Department, encourages applicants for the position of dispatcher to participate in our sit-along program. The program is designed to provide an opportunity to observe PenCom dispatch operations and procedures.

   Participation in the program requires that you: 
   Be a resident, a student, or potential applicant 
   Be at least 18 years of age 
   Have no criminal record 
   Have no medical restrictions that might jeopardize your safety or the safety of Department personnel 
   Be neat and clean in appearance when you arrive for your sit-along. Casual attire is acceptable. 

   All applicants are subject to a security check prior to approval. Applicants are also subject to cancellation by the Communications Supervisor, and may be disqualified without cause. 

   If you have any questions, please contact a Communications Supervisor at 360-417-4971. Once processed you will be contacted to schedule a Sit-Along in our Communications Center. Thank you for your interest.

4. First Name*
5. Middle Name*
6. Last Name*
8. Date of Birth*
9. Driver's License/State ID #*
10. State*
12. Home Address*
14. City*
15. State*
16. Zip*
18. Contact Phone Number*
19. Contact Email Address*

21. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    
    

23. Electronic Signature*

    1. I agree

25. I declare under penalty and perjury that the above information is true and correct. I do not have a criminal history and I authorize the Port Angeles Police Department to conduct a security background check, which includes: State Criminal History, Local Law Enforcement contacts, Driver’s License and Wants/Warrants check. 

    I understand that the above information is to ensure the safety of department personnel.

27. Signature*

    First M. Last

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29. 1. Receive an email copy of this form.
30. Email address

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