Citizens Police Academy Application
Please complete the following registration form for the Duluth Police Department Citizens Police Academy. By providing your electronic signature, you acknowledge that all information submitted is true and accurate and authorize the Duluth Police Department to conduct a criminal history check for the purpose of determining eligibility to participate in the Citizens Police Academy.
Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Date of Birth
*
-
Month
-
Day
Year
Date
Drivers License Number
*
License State
*
Upload Government Issued ID (Drivers License, Passport, etc.)
*
Browse Files
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Select the Academy you wish to register for
*
Please Select
English
Spanish
T-Shirt Size
*
Please Select
Small
Medium
Large
X-Large
Occupation
*
What experience, if any, have you had with law enforcement?
*
Have you ever been arrested for an offense other than a minor traffic violation?
*
Yes
No
If yes, please briefly explain the situation.
What do you expect to gain from our program?
*
How long have you lived or worked in Duluth?
Will you be able to attend all 7 sessions?
*
Yes
No
How did you hear about our program?(required)
*
Social Media
Friend
Other
Other (please specify):
*
Certification Statement & Background Investigation Consent
I hereby certify that the information provided in this application is true and correct to the best of my knowledge. I understand and agree that the Duluth Police Department is authorized to conduct any investigation of my personal history deemed necessary for consideration for participation in the Duluth Citizen’s Police Academy, including the Authorization to release Personal Information and Criminal History Record Information form.
Signature
*
Today's Date
*
-
Month
-
Day
Year
Date
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