The Official Site of the Los Santos Police Department

[Alex Jorgensen]

Los Santos Police Department
SUPPORT SERVICES BUREAU
Police Ride Along Application Form

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To assist us in reviewing your application, we request that you complete this questionnaire. The information that you provide will be used only for evaluation and suitability checks. Please read each question carefully and mark one response to each question that applies.

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1. Personal Information:

• 1.1 Last Name: Jorgensen
  1.2 First Name: Alex
  1.3 Middle Name:

• 1.4 Address: 108 West Eclipse Boulevard, Del Perro
  1.5 City: Los Santos
  1.6 State: San Andreas

• 1.7 Current Occupation: State Fire Marshal, San Andreas State Fire Marshals Office
  1.8 Phone Number: 25459752
  1.9 Date Of Birth: 11/01/1993
  1.10 Gender:
  • [X] Male
    [-] Female
    [-] Other

• 1.11 Ethnic Group / Race (mark only one)
  • [-] Black
    [-] Hispanic
    [-] Asian/Pacific Islander
    [X] Caucasian
    [-] American Indian
    [-] Filipino
    [-] Middle Eastern

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2. Criminal & Citation Record:

• The Los Santos Police Department conducts a Criminal Background check on all ride-along applicants. Applicants are also required to inform the Los Santos Police Department of any type of Criminal Background or interactions they may have had with the Department. Failure to do so will lead to an immediate denial of the application and possible restrictions on further applications.
  
  2.1 Please mark one of the following that best applies on the basis of severity:
  • [X] I have a clean Criminal Record.
  • [-] I have received Traffic/Infraction citations from San Andreas Law Enforcement that I have paid or had upheld in Court.
  • [-] I have been arrested by San Andreas Law Enforcement on Misdemeanour charges which I have pled Guilty/No Contest to or have had upheld in Court.
  • [-] I have been arrested by San Andreas Law Enforcement on Felony charges which I have pled Guilty/No Contest to or have had upheld in Court.

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3. Release & Waiver:

• As a condition precedent to being permitted to ride as a Ride-Along Observer in a vehicle or vehicles operated by any officer or person employed by the Los Santos Police Department, I the undersigned, waive any claim I may have against the Los Santos Police Department and the officers, agents and employees of the Los Santos Police Department for any loss of life, bodily injury, property damage or any other claim whatsoever that I may sustain as a result of riding as such Ride-Along Observer. I also promise I have read, and I understand all of the Ride-Along regulations. I further agree that this waiver of liability by me is binding on my legal representatives, heirs, and successors, and shall have the same legal effect as I have agreed to herein.
  
  3.1 Full Name (Signature):
  3.2 Full Name (Print Name): _Alex Jorgensen_
  3.3 Date: 21/01/2021

[Sol Vazquez]

VINCENT LAGORIO CHIEF OF POLICE

VESPUCCI HEADQUARTERS 1308 SAN ANDREAS AVE. PO BOX 325 LOS SANTOS, SAN ANDREAS

Dear Mr. Alex Jorgensen,

• Following a review of your application by a Recruitment Officer, we are happy to inform you that your application has been ACCEPTED.
  
  In addition, please ensure that you have understood the guidelines and the requirements of the program. Your ride along privileges will expire on 03/FEB/2021.

Kind regards,

Bain Hastings
Lead Recruitment Officer, Support Services Bureau

[Camilla Thompson]

JOCELYN INGRAM CHIEF OF POLICE

VESPUCCI HEADQUARTERS 1308 SAN ANDREAS AVE. PO BOX 325 LOS SANTOS, SAN ANDREAS

Dear Ms. Alex Jorgensen,

• Your ride-along privileges have now EXPIRED. You may re-apply if you still wish to remain in the ride-along program. From this day forward you are no longer permitted to go on a ride-along, unless a new request has been accepted.

Kind regards,

Camilla Thompson
Recruitment Officer, Support Services Bureau