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Cascades Gateway Park Patrol Application

Department of Community Services

Parks Operations Division

1460 20th St SE/ Bldg. #14 Salem, Oregon 97301-3503
Phone: 503-588-6336   FAX 503-588-6305
 
 
__________________________________________________________________________________
Last Name                                               First                                                               Middle Initial
 
__________________________________________________________________________________
Date of Birth                                           Work Phone                                                   Home Phone
 
__________________________________________________________________________________
Mailing Address                                                 City                                                           ZIP Code

Emergency Contact: __________________________________Phone Number: ___________________
*Minimum 8 hours per month required


Have you ever been convicted of a misdemeanor or felony? ___Yes ___No
 
If yes, please describe:

__________________________________________________________________________________

__________________________________________________________________________________
 
Note: A conviction will not necessarily bar you from volunteering. Each conviction will be judged on its own merits with respect to time, circumstances and seriousness.
 

By my signature below, I understand and agree to information above and certify that all answers to the questions and statements on the application are true and complete to the best of my knowledge. I understand that, should the City learn, at any time, of any misleading answers, my application may be rejected and my name removed from further consideration.

______________________________________________                   _________________________
Signature                                                                                                Date

Return signed application to the above address. Thank you.

 

Emergency
Information

 


All Parks Events

 

Map of Parks (pdf)

 

Parks Operations Division
1460 20th St SE
Salem, OR 97301
503-588-6336
Fax: 503-588-6305
SalemParks@cityofsalem.net
More Contacts

 

Page Last Modified: July 9, 2008

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