Citizens Police Academy Application

2. First Name

3. Last Name

5. Address1

7. City

8. State

9. Zip

11. Date of Birth

12. Email

14. Drivers License Number

15. Phone Number

16. Occupation

18. Why do you wish to attend the Citizens Police Academy?

20. List two references with phone numbers

22. Electronic Signature Agreement

    1. I agree.

    I authorize the Fayetteville Police Department to conduct a background investigation to obtain any information relating to my criminal history for the purpose of making a determination of my eligibility for the Citizen’s Police Academy.

24. Electronic Signature

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field