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Application for Participation Show Low PD Citizen’s Academy
Name: ____________________________________ Home Phone: ________________ Cell Phone: _________________ Email Address: ______________________________ Address: _______________________________________________________________ City: __________________ State: _____________ Zip Code: _____________________ Employer: __________________________________ Position: ____________________ Work Phone: _________________ Business Address: ___________________________ Driver’s License Number/State: _____________________________________________ Date of Birth: ______________________________ Male: _________ Female: ________ Organizations in which you
are involved. Awards or recognition received: Why do you wish to attend Citizen’s Academy? ________________________________________________________________________________________________________________________________________________________________________________________________________________________ How did you hear about the
Citizen’s Academy? Have you ever been
arrested/convicted of a crime? If so, explain:
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