Form Department: PDF Download
Submission email:


This form must be completed and returned to the Kernersville Police Department. It takes at least two weeks to process the form and do a background check. By signing this form, you are giving the Kernersville Police Department permission to complete a thorough criminal history check on you prior to the ride-along. Completing this form does not guarantee the applicant a ride-along. You will be contacted and informed if your application has been approved or denied. During that contact, the time and date of the ride-along will be established. In addition to this form, you may be required to complete additional paperwork at the time of the ride-along. Ride-along applicants will be given a safety briefing at the time of the ride-along. Any questions regarding ride-alongs or the application process should be directed to the Special Operations Division Commander during regular business hours at (336) 996-3679.