“Chances are someone you know has recommended the Citizens Police Academy. They have probably told you how interesting it is, and that you will have a lot of fun! It is absolutely true!”
Name:
Address:
City:
State:
Zip:
Business Name:
Business Phone:
* include area code
Home Phone:
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Social Security #
Date of Birth:
Driver License #
Expiration Date:
Issuing State of license
E-mail:
Have you ever been arrested? If yes,
please explain:
No
Yes
Explain below any medical conditions that will prevent
you from participating in certain events:
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