Citizens Police Academy

Citizen's Police Academy Application

Mount Pleasant Police Department
Date Submitted:

MonthDayYear
Date
Name:

First NameLast Name
Address:

Address

Street Address Line 2

CityStateState

Zip Code
Date of Birth:

MonthDayYear
Date
Drivers License #:
Driver's License / Photo ID:

Cancelof
Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Email:
example@example.com
Do you have a handgun carry permit?
Employer:
Position:
Employer Address:
1. Have you ever been convicted of a felony?
Date of convictions:

MonthDayYear
Date
Charges:
City / State:
2. Have you ever been convicted of a misdemeanor?
Date of convictions:

MonthDayYear
Date
Charges:
City / State:
Why do you wish to attend the Citizen's Police Academy?
By signing below, I certify that all statements made on this application are accurate and Mount Pleasant Police Department has my consent to conduct a basic background investigation prior to admittance into the program.
Applicant Signature
Date

MonthDayYear
Date
Should be Empty:

Citizen's Police Academy Application