CPA Application

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Complete this application if you are interested in joining the Citizen Police Academy every Wednesday starting April 11th through May 30th, 2018.

Please correct the field(s) marked in red below:

1
Last Name
 *
2
First Name
 *
3
Date of Birth (Mo-Day-Year format)
4
Address
 *
5
City, State and Zip
 *
6
Home or Cell Number to Reach You
 *
Applicants in the program may be exposed to sensitive law enforcement information. We do screen applicants to determine who we allow into our unique program.  The following information may be used for that purpose.
7
Occupation
 *
8
Employer
 *
9
Employer Address, City State and Zip
 *
10
Employer Telephone
11
Please describe why you want to attend this program.
 *

Applicants will be expected to sign a Release of Liability form before taking part in the program.  Additionally, a records check will be conducted on all participants prior to the start of the academy.  Anyone with activities or arrests that are in conflict with the mission and values of the police department will not be accepted.

 

  1. To receive a copy of your submission, please fill out your email address below and submit.