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.
Email:
example@example.com
Do you have a handgun carry permit?*

YesNo
Employer:*
Position:
Employer Address:
1. Have you ever been convicted of a felony?*

YesNo
Date of convictions:

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

YesNo
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*

Clear
Date

MonthDayYear
Date
Should be Empty:

Citizen's Police Academy Application