Attention: this is not a job application. This is a form to enroll in an educational class for citizens to learn more about what police do on a day-to-day basis.

Applicants must be residents, business owners, or employees within the corporate city limits of Goodlettsville, be 21 years of age, and complete the application form, which includes information to complete a background check. Applicants must be committed to class dates and cannot miss more than two (2) classes. Applicants will be notified of acceptance into the Academy.

Last Name

First Name

M.I.

Home Address

Email

Home Phone

Office Phone

Cell Phone

Drivers License Number

D.L. State

D.L. Class

D.L. Expiration Date

Valid License? (Y/N)

Have you ever been convicted of a felony?

If yes, explain where, when, and disposition.

Place of Employment

Employer's Address

Duties Performed

Why do you want to become a member of the Citizens Police Academy?

Attach any supportive material you consider relevant to the application.

T-shirt Size

Small Medium Large X-Large XX-Large

I certify that all statements made on this application are true and correct. I authorize any individual, company, organization or institution to release any and all information concerning statements made by me on this application, and I do hereby release all parties and individuals connected from all liabilities for any damages whatsoever incurred in furnishing misstatements or omission of material facts which may disqualify me to attend the Citizens Police Academy. My initials below acknowledge my understanding and agreement with material provided.

Initials

Date