Berlin Police Department - Junior Police Academy Application 2025

Berlin Police Department

2025 Junior Police Academy Registration
59 S White Horse Pike, Berlin NJ 08009

Det. Ashton Pohlig #72

Phone: 856-807-1022

Email: APohlig@BerlinPolice.Net

Dates of Junior Police Academy 2025 - June 23th - June 27th

Times are subject to change but are traditonally 8AM until Afternoon hours.

Each child must be 8 to 14 years old
Applicant Name*

First NameLast Name
Personal Information*

DOBSchool / Grade
Information
My child attends Berlin Community School or Our Lady of Mount Carmel School or resides in the Borough of Berlin*
Are you between the ages of 8 & 14?*

YesNo
Guardian / Parents Names*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Cell Phone
E-mail*
example@example.com
Guardian / Parents Names

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Cell Phone
E-mail
example@example.com
Please list any medical information in relation to over the counter or prescription medications. Please also note any allergies that your child may have. This information is confidential and is only to be used in the case of an emergency. If the response is none, please type "none" on the line below.*
Please list below why you or your child are interested in the Berlin Police Department Junior Police Academy. This submission will be used instead of a sponsorship letter. Please list in detail below.*
Have you ever been arrested, convicted or charged with any offense or been in trouble in school? If yes, explain below, if no, type "none" in the space below.*

YesNo
Please Explain or Type None*
Emergency Contacts - Two are required
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
I have read and agree to the above conditions*

YesNo
I have confirmed that I am a resident of Berlin Borough or have an exemption prior to filling this form out.*

YesNo
Confirmation E-mail*
example@example.com
Should be Empty: