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Apply for Citizens Police Academy

Name:

Address:

City:

State: Zip:

Phone:

Date of Birth:

Social Security Number:

Place of Employment:

Check Mate #: (if applicable)

Interested in:

Spring Class Fall Class

Interested in volunteering with the department? Yes No

By submitting this electronic form I certify that I understand that an NCIC/CLEAN warrant check will be conducted to determine if there are any outstanding warrants on me and I agree to this check. I understand that false information provided in this application may preclude my participation in this program.

 
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