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Get FL Clearwater Police Department Volunteer Program Application 2013

___________________________ EMAIL ADDRESS: STATE_____________ HOME TELEPHONE: ZIP_____________ WORK TELEPHONE: DATE OF BIRTH:_______/_______/_______ SOCIAL SECURITY: _______-_____-________ GENDER: FEMALE MALE DO YOU POSSESS A VALID FLORIDA DRIVERS LICENSE? YES NO DRIVERS LICENSE OR ID NUMBER: ___________________________________________________ EXPIRATION DATE:_______/________/________ DRIVING PRIVILEGE EVER BEEN SUSPENDED OR REVOKED? YES NO IF YES – WHEN, WHY AND WHERE:________________.

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