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Parks
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Minto-Brown Island Park Patrol Application
____________________________________________________________________________ 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: _______________________________________________________________
Driver's License Number: _________________________________ State of Issue: __________
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 Please return signed application to the above address. Thank you.
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Emergency Information
EventsAll Parks Events
MapsMap of Parks (pdf)
Contact UsSalemParks@cityofsalem.netMore Contacts
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Page Last Modified: July 9, 2008
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