Montgomery Police Department Citizens Police Academy

Montgomery Police Department Citizens Police Academy - Application
Applicants must be 18 years of age or older to attend Academy. No prior felony convictions.

This application is due no later than 30 days prior to the first day of class in order to be considered. There are only 20 openings in each academy class; therefore, not every applicant will be accepted. An eligibility list will be established for last minute cancellations. You will be notified the week prior to the start of class of the status of your application.
Date of Application:*

MonthDayYear
Date
Name:*

First NameMiddle InitialLast Name
Maiden Name:
Date of Birth:*

MonthDayYear
Date
Age:*
S.S#:*
Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing address if different:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone:*
E-Mail Address:*
example@example.com
Emergency Contact:*
Relation:*
Address:*
Phone:*
Place of Employment:*
Occupation:*
Work Phone:*
List all memberships in community groups, civic organizations, etc:*
What is your objective in enrolling in the Citizen's Academy and why should you be considered?*

Montgomery Police Department Citizens Police Academy - Application
If you are accepted as a student, you will receive instruction and educational materials related to the law enforcement mission of the Montgomery Police Department. As the material presented will be of a privileged or confidential nature and due to the sensitivity of the information, it is necessary for the Montgomery Police Department to conduct a background check to determine suitability of those persons desiring to attend the academy classes. Please answer the following questions as accurately and completely as possible. Any intentional misrepresentation or omission of facts will be grounds for denial of admission to the academy, or if already enrolled, immediate termination. Acriminal history check will be made on all persons making application for enrollment. Class A and Class B Misdemeanor convictions will be accepted only on a case by case basis. No violent criminal offenses or felony convictions will be accepted.
Driver's License Number:*
State:*
Do you go by any other names or aliases now or have you in the past?*

YesNo
If yes- Explain: (Do not include maiden name unless used in the last 5 years.)*
Are you a member of, or ever been affiliated with a law enforcement agency?*

YesNo
If yes- Explain:*
Have you ever lived outside of the U.S. (or its territories) in excess of 90 days?*

YesNo
If yes- Explain:*
Have you ever been convicted of a Class B, Class A or Any Felony Offense, or are you currently on probation for any offense?*

YesNo
If yes- Explain:*
APPLICANT MUST COMPLETE THE FOLLOWING:
I hereby acknowledge that I have completed the above application completely and accurately to the best of my knowledge. I also acknowledge that the Montgomery Police Department will be conducting a background investigation on me to determine my suitability for admission to this program. Permission is hereby granted to perform a background investigation based on the information given in this application.
Name*
First and Last Name
Date:*

MonthDayYear
Signature*

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By clicking this box, I acknowledge the above statement and choose to electronically submit my application.

Montgomery Police Department Citizens Police Academy - Application
POLICE RIDE-ALONG RELEASE OF LIABILITY
WHEREAS, the undersigned has requested the privilege of accompanying members of the Montgomery Police Department in the carrying out of their official duties; and

WHEREAS, the undersigned is fully aware of the dangers and possible consequences of accompanying police officers in the administration of their duties, including personal injury or death; and

WHEREAS, the Montgomery Police Department is committed to developing a community awareness of functions and routine tasks of police officers in the course of their daily affairs:

NOW THEREFORE, in consideration of the privilege of being allowed to accompany various officers of the Montgomery Police Department in the carrying out of their official duties, I, the undersigned, covenant and agree with the City of Montgomery, the Montgomery Police Department, its police officers and all other officers, employees and agents of the City of Montgomery, that I will never institute or prosecute any claim, suit or action at law or otherwise against the City of Montgomery, nor its employees, nor will I institute, prosecute or in any way aid in the institution or prosecution of any claim, demand, action or cause or action for damages, loss or injury either to person or property, or both, which may arise or which I, my heirs, executors, administrators hereafter may have for or by reason of my participation in an on-site observation of the activities of the Montgomery Police Department. I further agree to indemnify and hold harmless all such parties against any claim or cause of action arising out of or related to any of my actions or failure to take action committed in the course of accompanying such officers.
THE UNDERSIGNED EXPRESSLY WAIVES ALL RIGHTS OF ACTION, CLAIMS AND DEMANDS AGAINST ALL PERSONS WHOMSOEVER CONNECTED TO THE CITY OF MONTGOMERY, TEXAS.
IN WITNESS WHEREOF, I have hereunto set my hand this the _______ day of ______________________, 20____.
(Printed Name of Applicant)*
(Address of Applicant)*
Should be Empty:

Montgomery Police Department Citizens Police Academy - Application

Montgomery Police Department Citizens Police Academy - Application

Montgomery Police Department Citizens Police Academy - Application

Montgomery Police Department Citizens Police Academy - Application

POLICE RIDE-ALONG RELEASE OF LIABILITY