CITIZENS POLICE ACADEMY
REGISTRATION FORM

Name:__________________________________________________________________
Address:________________________________________________________________
Home Phone__________________________Business Phone_____________________
Texas drivers License Number:_____________________________________________
Date of Birth:_________________________Occupation:________________________

Reason for wanting to attend the Citizens Police Academy:
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Do you have any close family that work in Law Enforcement?
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Have you ever been contracted by the Police Department? Either for a traffic violation,

reporting a crime, needing assistance, etc.? What was your impression of the officer and the department?
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