Section 1 of 1 in this document
Citizens' Academy Application Form
Please complete the application form for the Academy enrollment.
Are you 21 years or older?
YES
NO
Full Name
First Name
*
Initial
Last Name
*
Nickname(s)
Date of Birth
Month
*
MM
January
February
March
April
May
June
July
August
September
October
November
December
Day
*
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
*
YYYY
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
Place of Birth
Full Address
Street Address
City
State
Zip
Telephone (Main)
Telephone (Work)
Email
Citizenship
US
Naturalized
Other
Driver's License Number
State License was Issued
Ethnic Background (specify)
Do you have Law Enforcement Experience?
Yes
No
Current Occupation
Employer
Please explain your reason for attending the Citizen's Academy.
*
NOTE -
A Criminal Background Check will be completed due to police sensitivity issues.
Background Check Consent
Yes, I give the CMPD permission to conduct a standard background check of my person.
No, I do not give my consent.
disregard this