Police Youth Club Membership Application - Trinidad and Tobago Police Service

1

Club Details

The Police Youth Club you are applying to join.

Name of Club *

For example, Indian Walk

Station District *

2

General Member Information

Details of the person applying for membership.

First name *

Surname *

Alias / Nickname

Date of birth *

Gender *

Male

Female

person

Member Picture

Passport style photo, JPEG, PNG or WEBP, up to 5 MB

Contact

Community *

Email

Address *

Phone 1 *

Phone 2

Personal

Current school

Marital status

Religion

Blood type

Health issues

Any medical conditions, allergies or medication our officers should know about during activities

Work

Employer

Occupation

Work phone

Talents, Hobbies and Groups

Talents

Hobbies

Social Group 1

Position Held (Group 1)

Social Group 2

Position Held (Group 2)

Emergency Contact

Emergency Contact Name *

Emergency Contact Phone *

3

Education, Training and Certified Skills

List the highest level first.

Institution	Level Attained	Details of Certification / Skill	Date Completed	TTPS Funded

4

Grades

Results for the term before joining. Complete if currently in school.

Name of School

Academic Year

For example, 2025/2026

Class

Term

Overall %

Remarks

Subjects

5

Spouse and Children

Complete only if applicable.

Name	Gender	Relationship	Date of Birth	School / Occupation

6

Parents and Guardians

Required for applicants under 18. At least one parent or guardian must be provided.

Male Parent or Guardian

Parent

Guardian

Full name

Mobile

Work phone

Employer

Occupation

Special skill

Lives with member

Female Parent or Guardian

Parent

Guardian

Full name

Mobile

Work phone

Employer

Occupation

Special skill

Lives with member

7

Interests

Tell us what you would like to take part in.

How did you learn about the PYC?

Please specify

Activities you may be interested in

These are not necessarily all available at this Police Youth Club at this time, but your choices may be used to inform future activities or to direct you to your nearest PYC offering them.

8

Consent and Agreement

Enter the date of birth above to see the correct declaration.

Full name (typed signature) *

Parent or guardian name if the member is under 18, otherwise the applicant name

Date

Recorded automatically when you submit

I confirm that the information given in this application is true and I agree to the declaration above.

Membership Application

Club Details

General Member Information

Education, Training and Certified Skills

Grades

Spouse and Children

Parents and Guardians

Male Parent or Guardian

Female Parent or Guardian

Interests

Educational

Cultural

Sporting

Skill Based

Personal Development

Environmental