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DEPARTMENT OF MEDICAL EXAMINER-CORONER RIDE ALONG PROGRAM INFORMATION
DEPARTMENT OF MEDICAL EXAMINER-CORONER RIDE ALONG PROGRAM INFORMATION
REQUIREMENTS:
- Be 18 years of age
- Civilian ride alongs are NOT allowed to carry any type of firearm or weapon, regardless of any permit.
- Sign the Ride-Along Release Form prior to engaging in the Civilian Ride-Along Program
- Dress in business-like attire
- Not be a user of illegal narcotics or an excessive user of alcohol
- Be willing to follow all lawful orders and/or instructions given by the Deputy Coroner with whom you are assigned
The following factors may be considered in disqualifying an applicant and are not limited to:
- Prior criminal history
- Pending criminal action
- Pending lawsuit against the Department
- Must not currently be under a driver’s license suspension or revocation from DMV
- Must not have warrants outstanding for their arrest
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DEPARTMENT OF MEDICAL EXAMINER-CORONER RIDE ALONG PROGRAM APPLICATION
DEPARTMENT OF MEDICAL EXAMINER-CORONER RIDE ALONG PROGRAM APPLICATION
- Title: Mr./Mrs./Miss./Dr./Ms.
- First name(s): Answer
- Last name: Answer
Date of Birth: DD/MM/YYYY
Phone number: Answer
Place of Birth: Answer
Nationality: Answer
Residential address: # Street Name, City, State
What is the reasoning behind your ride along?: Answer
Personal Statement Agreement:
SIGNATURE: SignatureI the undersigned aware that the work of the Department of Medical Examiner-Coroner personnel is inherently dangerous and that he/she may be subjected to the risk of death, personal injury, or damage to his/her property by accompanying a member or members of the Department of Medical Examiner-Coroner during the performance of their official duties. The undersigned voluntarily assumes the risk of death, personal injury, and property damage arising from or in any way connected with riding along in an Department of Medical Examiner-Coroner vehicle.
DATE: DD/MM/YYYYBackground Authorization:
SIGNATURE: SignatureI understand that a criminal check and a warrant check will be conducted as part of the application process.
I hereby authorize any law enforcement agency, agencies of the government of the United States of America,
and agencies of the State of San Sndreas to release to the Department of Medical Examiner-Coroner any and all information which said agencies or any of them have about me, for the limited purpose of aiding the Department of Medical Examiner-Coroner in evaluating my eligibility for participation in the Ride Along Program. This release extends to any and all information which said agencies or any of them may have about me, whether public, personal, or confidential. I understand that I will not receive and am not entitled to know the contents
of confidential reports received from these agencies and I further understand that these reports are privileged and
confidential. I hereby release, discharge, and agree to hold harmless the agencies, their agents and representatives and
any person furnishing such information from any and all liability of every nature and kind arising out of the furnishing and
inspecting of such documents, records and other information, and this release shall be binding on my legal representatives, heirs and assigns
DATE: DD/MM/YYYY
Code: Select all
[Ride-Along] Firstname Lastname
Code: Select all
[divbox=white][color=#FFFFFF].[/color]
[center][img]https://i.imgur.com/HNF4Wyu.png[/img]
[size=200][b]DEPARTMENT OF MEDICAL EXAMINER-CORONER RIDE ALONG PROGRAM APPLICATION[/size]
[/center][/b]
[hr][/hr]
[list=none][*][b]Title: [/b] Mr./Mrs./Miss./Dr./Ms.
[hr][/hr]
[*][b]First name(s): [/b] Answer
[hr][/hr]
[*][b]Last name: [/b] Answer
[hr][/hr]
[b]Date of Birth: [/b] DD/MM/YYYY
[hr][/hr]
[b]Phone number: [/b] Answer
[hr][/hr]
[b]Place of Birth: [/b] Answer
[hr][/hr]
[b]Nationality: [/b] Answer
[hr][/hr]
[b]Residential address: [/b] # Street Name, City, State
[hr][/hr]
[b]What is the reasoning behind your ride along?[/b]: Answer
[hr][/hr]
[divbox=white]
[b]Personal Statement agreement:[/b]
[quote]I the undersigned aware that the work of the Department of Medical Examiner-Coroner personnel is inherently dangerous and that he/she may be subjected to the risk of death, personal injury, or damage to his/her property by accompanying a member or members of the Department of Medical Examiner-Coroner during the performance of their official duties. The undersigned voluntarily assumes the risk of death, personal injury, and property damage arising from or in any way connected with riding along in an Department of Medical Examiner-Coroner vehicle.[/quote]
[b]SIGNATURE: [u]Signature[/u]
DATE: DD/MM/YYYY[/b]
[/divbox]
[divbox=white][b]BACKGROUND AUTHORIZATION:[/b]
[quote][left]I understand that a criminal check and a warrant check will be conducted as part of the application process. I hereby authorize law enforcement agency, agencies of the government of the United States of America, and agencies of the State of San Andreas to release to the Department of Medical Examiner-Coroner any and all information which said agencies or any of them have about me, for the limited purpose of aiding the Department of Medical Examiner-Coroner in evaluating my eligibility for participation in the Ride Along Program. This release extends to any and all information which said agencies or any of them may have about me, whether public, personal, or confidential. I understand that I will not receive and am not entitled to know the contents of confidential reports received from these agencies and I further understand that these reports are privileged and confidential. I hereby release, discharge, and agree to hold harmless the agencies, their agents and representatives and any person furnishing such information from any and all liability of every nature and kind arising out of the furnishing and inspecting of such documents, records and other information, and this release shall be binding on my legal representatives, heirs and assigns[/quote][/left]
[b]SIGNATURE: [u]Signature[/u]
DATE: DD/MM/YYYY[/b]
[/divbox]
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