St. Louis Metropolitan Police Department

St. Louis Metropolitan Police Department

Community Engagement and Recruitment Unit
Citizens Academy Application

Please fill out completely. If a required response does not apply, type N/A in the space provided.
Personal Information
First Name*
Last*
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
If you are a St Louis City resident, how long have you resided at this address?*
Date of Birth*

MonthDayYear
Date
Age*
Gender*
Drivers License/ Permit #*
Issuing State*
Expiration Date*

MonthDayYear
Date
Email Address*
example@example.com
If you own a business in the City of St. Louis, please complete the following section:
Business Name*
If none, type N/A
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number:*
If none, type N/A
Years of Ownership
Emergency Contact Information
Name*
Relationship*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employment Information
Employers Name*
Position*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer's Phone Number
Please enter a valid phone number.
References

Please list two character references who are not relatives.
1. Name*
Phone Number*
Occupation*
Years Acquainted*
Relationship to Reference*
2. Name*
Phone Number*
Occupation*
Years Acquainted*
Relationship to Reference*
Involvement Information
Please list any civic groups, neighborhood associations or groups, business or professional organizations to which you belong (optional):*
Have you had any previous law enforcement training or experience? If so, please explain.*
Why are you interested in participating in the Citizens Academy?*
Criminal History
Have you ever been arrested, detained, taken into custody or convicted of a crime in this state, any other state, in military service, or elsewhere? If so, please provide the date, actual charge or violation, location (city/state), court disposition or sentence, police agency concerned. Minor City Ordinance/Traffic Convictions need not be listed unless you were arrested.*
Type N/A if this does not apply.
Applicants who are found to have committed any serious crimes may be excluded from consideration even if no conviction occurred. Applicants who are found to have intentionally falsified or omitted any information from this application will be disqualified from further consideration.

I certify that answers given in this internship application are true and complete to the best of my knowledge. I understand and agree that the St. Louis Metropolitan Police Department will perform a criminal history inquiry.
Signature of Applicant*

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St. Louis Metropolitan Police Department

Citizens Academy Application

Personal Information

Emergency Contact Information

Employment Information

References

Involvement Information

Criminal History