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Citizens Academy Application
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Personal Information
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Contact Information
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Additional Information
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References
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Personal Information
First Name
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Last Name
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Date of Birth
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Date of Birth
Gender
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Contact Information
Address
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Email Address
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Phone Number
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Emergency Contact
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Emergency Contact Relationship
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Emergency Contact Phone Number
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Employment Information
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Occupation
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Employer Address
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Employer City
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Employer State
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Additional Information
Why do you wish to attend the Citizen's Academy?
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How did you hear about the Citizen's Academy?
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Have you ever been arrested, charged, or given notice or summons to appear for any criminal violation?
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No
If yes, please explain the charge, law enforcement agency, date and disposition of the case.
Have you ever been served with a restraining order or no contact order?
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If yes, please explain the reason, location and disposition.
Have you ever been placed on probation?
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References
Reference 1 Name
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Reference 1 Phone Number
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Reference 1 Complete Address
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Reference 2 Name
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Reference 2 Phone Number
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Reference 2 Complete Address
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