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Memorandum CN:
FOR : Training Manager Company:___________________
SUBJECT : Request for Ordinary /Emergency Pass
DATE :____________________________
1. Request that the undersigned be granted ______ days’ ordinary/emergency pass
From:______________________ To: _____________________________
Time: ______________am/pm Time: ______________am/pm
2. That this request is being made for the following reason(s):
a. _________________________________________________________________________
b. _________________________________________________________________________
3. That my contact no. and address while on pass is at:
________________________________________________________________________________
4. That while on pass, I will not enter bars, clubs, gambling dens and house of ill refute.
5. Further request approval.
____________________________
Full Name & Signature
________________________________ ______________________________
Field Training Officer Chief of Police
Noted by:
Approved/Disapproved:
Memorandum CN:
FOR : Training Manager Company:___________________
SUBJECT : Request for Ordinary / Emergency Pass
DATE :___________________________________
6. Request that the undersigned be granted days’ ordinary/emergency pass
From:_______________________________ To: _____________________________
Time: ________am/pm Time:_______________am/pm
1. That this request is being made for the following reason(s):
a. _______________________________________________________________________________
b. _______________________________________________________________________________
2. That my contact no. and address while on pass is at:
______________________________________________________________________________________
3. That while on pass, I will not enter bars, clubs, gambling dens and house of ill refute.
4. Further request approval.
_____________________________
Full Name & Signature