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Shop with a Cop Nomination Form
Child's Information
$0 - $ 20,000$20,001 - $40,000
$40,001 - $60,000$60,001 - $85,000
$85,001 - $105,000$105,001 - over

* Shop with a Cop is a program that rewards children with the opportunity to purchase necessities while shopping with a police officer. Children nominated are selected based on their financial need and their commitments to staying in school, fighting adversity and making good choices. Please describe how the child you are nominating fits this criteria.

Nominator's Information

If other, please specify

Security Measure