University of Minnesota Duluth
 
 

 UMD Police Department

(*) = Required information. You MUST completely fill out this form, incomplete forms will not be accepted. This form must be completed and sent to UMDPD (via the "Submit" button) at least 7 days prior to the date you wish to ride.  See the following link to the ride-along agreement form you will be required to sign. Ride-Along Form
Your Information - Person requesting services.
 
* Full Name :
* Date of Birth :  (MM/DD/YYYY)
* Phone :  (xxx-xxx-xxxx)
* Email:  
*University Student or Staff : If yes *Student ID#
*Have you ever been arrested for, charged with, or convicted of a crime other than driving offenses?
* If you answered "Yes" to the above question, what were the circumstances, when and where did it occur?
* Reason for ride along.
* Ride alongs are provided in blocks, please indicate the date and time you would like to ride.

(MM/DD/YYYY)

   
         
© 2016 University of Minnesota Duluth
The University of Minnesota is an equal opportunity educator and employer.
Last modified on 09/21/16 09:00 AM
University of Minnesota Campuses
Crookston | Duluth | Morris
Rochester | Twin Cities | Other Locations