Form
Celina Police Department Citizen's Police Academy 2026
Applicant Information
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Prefer not to answer
Race/Ethnicity
Please Select
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian and Other Pacific Islander
White
People of two or more races
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Home/Cell Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Drivers License Number
State
Are you over the age of 18 years of age?
Please Select
Yes
No
Do you live, work, or own a business in Celina, Texas?
Please Select
Yes
No
How did you learn of Citizen’s Police Academy?
Please Select
Referral/Friend
Celina Website
Police Social Media
Celina Social Media
Google Search
Other
Why are you interested in the Citizen’s Police Academy?
Will you commit to attending a minimum of 80% of the class sessions?
Please Select
Yes
No
Employment Information
Occupation
Name of Company
Employer's Address
Emergency Contact Information
Adult over the age of 18
Name #1
First Name
Last Name
Relation to Applicant
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Name #2
First Name
Last Name
Relation to Applicant
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Background Information
Have you ever been arrested for, convicted of, or cited for an offense other than a traffic violation?
Please Select
Yes
No
If Yes, please explain:
Are there any medical conditions that would prohibit you from participating in any of the activities in the academy?
Please Select
Yes
No
If Yes, please explain:
Do you have any membership in community groups, civic organizations, or prior citizen’s academies such as: Citizens Government Academy or Citizens Fire Academy?
Please Select
Yes
No
Do you consent to a Criminal History and Driver’s License background check?
Please Select
Yes
No
Will you be willing to sign a Waiver from the City of Celina?
Please Select
Yes
No
Will you be willing to place your name and contact information on a group contact list?
Please Select
Yes
No
Are you willing to further volunteer for the Celina Police Department after completion of this Citizens Police Academy?
Please Select
Yes
No
Thank you for your interest in joining Celina's Citizens Police Academy!
If you have any further questions, please contact Officer John Thacker #642 at jthacker@celina-tx.gov.
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