Approval StatusPending Review

PHOTO ID REQUIRED (copy will be retained). APPLICANTS MUST BE AT LEAST 14 YEARS OF AGE

NameKathy Dryden
Cell Phone9712277356
Home Address4010 Cranston St SE
Salem, Oregon 97317
Map It
Date of Birth12/18/1997
SSN #540532334
Driver License Number & StateA194468 OR
Purpose of Ride

I would like to ride with Bella Federico

Emergency Contact Information
Emergency Contact NameAdam Dryden
Emergency Contact Phone5038318198
Date You Want to Ride05/23/2026
Time Requested05:00 PM
Patrol observation rides are a maximum of 5-hour duration. You are limited to 1 ride per calendar year. Please schedule as far in advance (7 DAY MINIMUM) as possible. You will be contacted by telephone to confirm whether or not there is a vacancy for the date and time you have selected. IF SELECTED TO RIDE, YOU ARE BEING REQUESTED TO SHOW UP WEARING CLOTHING DEEMED AS BUSINESS CASUAL.
Ride Rules & Acknowledgements
Consent I agree to the privacy policy.
Are you under 18 years of age?No
Applicant SignatureSignature
Date05/19/2026
Parent/Guardian Signature
PD Department Use Only
Records CheckAttach ONLY: Arrest info, Suspect info, Concealed Weapon Permit info, Corrections Client Info
For Officer to Complete