Community Academy Application Form

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PETALUMA POLICE DEPARTMENT
CITIZEN POLICE ACADEMY
Application
Date Completed:
Date Received:
(Office Use Only)
PERSONAL INFORMATION
Full Name:
Date of Birth:
Driver’s License - State/#:
Home Ph#:
Home Address:
City:
Employer:
Work Ph#:
Work Address:
City:
Occupation:
How Long?:
Email Address:
Cellular Ph#:
How long have you lived in Petaluma?
Worked in Petaluma?
PLEASE ANSWER ALL QUESTIONS
(Continue on Second Page if Necessary)
1) Please describe your reason for wanting to attend the Citizen Police Academy
2) Please describe any community involvement or other related activities you have participated in

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