Application for Enrollment
Cedar Hill Citizen Police Academy

Full Name*

Date of Birth (MO/DA/YEAR)*

Drivers License, State and Number*

Home Address*

City

Home Phone (10 digits no dashes or spaces)

Cell phone (10 digits no dashes or spaces)

Email

Work Address

Work Phone (10 digits no dashes or spaces)

Have you ever been arrested or convicted of any crime?*

Yes

No

If "Yes" please explain

I hereby certify that the answers and other information on this application are true and correct and that I understand any misrepresentation or omission of facts on my part will be justification for exclusion from the Cedar Hill Citizen Police Academy. I understand that my acceptance may be contingent upon a background investigation by the Cedar Hill Police Department. A prior conviction will not automatically disqualify any applicant and will be considered only as it relates to the academy. I understand that attending this academy in no way makes me a police officer, that the CHCPA is strictly to inform me how this agency operates.

Full Name*

Date of application (MO/DA/YEAR)*