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Cop Camp Application

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Name of Applicant*
Address1*
Address2
City*
State*
ZIP*
Name of Parents*
Home Phone*
Emergency Phone 1*
Emergency Phone 2*
Child's Age on June 1, 2015*
Must be 10 or 11.
Sex*
Date of Birth*
Date of Birth
Shirt Size*
1. Small
2. Medium
3. Large
Name of School*
Good Conduct Endorsement by School Official
Please have signed.
Pervious Police Camps attended?*
1. Yes
2. No
Return no later than June 1, 2015 to:
Whitemarsh Township Police
Attn: Sgt. Brian Mack
616 Germantown Pike
Lafayette Hill, PA 19444