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Wyckoff Police Department

Scott Plaza
Wyckoff, New Jersey 07481
201-891-2121

CROSSING GUARD APPLICATION
Name
E-mail address:
Social Security #
Address
Home Phone
Number
Blood Type
Drivers License #
Emergency Contact Name
Emergency Contact #
Relationship
Do you own and operate a motor vehicle?
Yes
No
Are you available for all school days?
Yes
No
Do you have any serious illness or affliction? If so, would this affect your performance as a Crossing Guard? (Explain)
Have you ever been arrested?
Yes
No
If so, give details and dates:
Previous employment:
Submit my application