Join the Citizens Academy

Join the Citizens Academy
Name

First NameLast Name
DOB (mm/dd/yy)

MonthDayYear
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Zip Code
Occupation
Employer
Employer Address

Street Address

Street Address Line 2

CityState

Zip Code
Business Phone
Please enter a valid phone number.Format: (000) 000-0000.
Drivers License Number
Drivers License State
Social Security Number
Do you have any law enforcement experience?
If Yes, please explain:
Have you ever been arrested or adjudicated for a crime other that a traffic violation?
If Yes, provide details of arrest(s) and/or conviction(s):
Please Provide one character reference, other than a relative, who has known you for at lease three (3) years.
Reference Name

Reference First NameMiddle NameReference Last Name
Years Acquainted
Reference Address

Street Address

Street Address Line 2

CityState

Zip Code
Reference's Occupation
Reference's Employer
Reference's Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference's Business Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference's Email Address
example@example.com
Do you have any special needs? (hearing impaired, etc.)
Please list any Citizens Academies you have attended in the past.
How did you hear about the Sheriff's Citizens Academy and why do you want to attend?
Please verify that you are human
Should be Empty:

Please Provide one character reference, other than a relative, who has known you for at lease three (3) years.