Approval StatusPending Review

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

NameFernando E Palafox
Home Phone5039834567
Cell Phone9716006157
Home Address846 Blackbird CT NE
Salem, Oregon 97301
Map It
Date of Birth02/26/2004
Driver License Number & StateA133040
Purpose of Ride

learn about the career, overall questions about policing and a day in the life of a police officer

Emergency Contact Information
Emergency Contact NameMaria Palafox
Emergency Contact Phone5039834567
Date You Want to Ride09/05/2026
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
Date08/27/2026
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