CMPD Youth Academy Enrollment Application
Enrollment to this Academy
Enrollment into this Academy
Choose One CMPD Middle School Academy CMPD High School Academy CMPD Explorers Academy CMPD Leadership Academy CMPD Teen CERT Academy CMPD Latino High School Academy
Applicant Information
Last Name
First Name
Nicknames or Aliases
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
Age
Race
Home Address
City
State
Zip Code
Email Address
Home Phone Number
Mobile Phone Number
High School Attending
Current Grade Level
School Resource Officers SRO Name
SROs Email Address
School Guidance Counselor's Name
Counselor's Email Address
Parent / Guardian Information
Parent/Guardian Name(s)
Parent/Guardian Home Phone
Parent/Guardian Work Phone
Parent/Guardian Email Address
Parent/Guardian Home Address
City
State
Zip Code
Emergency Contact Information
Emergency Contact Name(s)
Relationship to Applicant
Emergency Contact's Work Phone
Emergency Contact's Home Phone
Emergency Contact's Mobile Phone
Criminal History
Explanation of criminal history, if answered YES to any of the above questions.
Questions
1. What do you hope to gain by attending the High School Police Academy?
2. What type of community and/or volunteer activities do you participate in and how do you think that these activities impact our society?
3. Tell us something about yourself. How do you like to spend your free time? Hobbies?
4. Due to recent events in the media what is your opinion of the Law Enforcement?
5. What qualities and/or characteristics may distinguish you from other applicants?
