2. Name*
4. Address*
6. City*
8. State*
10. Zip Code*
12. Phone Number*
14. Date Of Birth*
16. Drivers License*
18. Occupation*
20. Business Phone Number*
22. 
    
24. Email
26. 
    
28. How did you hear about the Citizen's Fire Academy
30. 
    
32. What is your purpose for attending?
34. 
    
36. Have you ever been convicted of a felony*
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38. 
    
40. If yes, Please explain.
42. 
    
44. List name,address and phone numbers of 2 references*
46. 
    
48. T-Shirt Size*
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