Citizens Academy Application

PERSONAL























*Have you ever been arrested or convicted of a crime?:



*Have you ever been involved in a civil suit? :



*Do you have any pending court cases?:



OCCUPATION



*Have you ever, or are you currently serving in the Armed Forces? :

About the Program















MEDICAL HISTORY



List three (2) people to be contacted in case of an emergency:
Name:
Phone:

Please Read Waiver before signing Waiver & Release




Today

Answer the question below:
Is two < than four? (true/false)