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Personal Information

First and Last Name:*
Date:*
Date:
Address:*
City, State, Zip:*
Email:*
Phone Number*
Date of Birth*
Date of Birth
Employer:
Occupation:
Work Phone Number:
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Additional Information

2. List organization(s) you are involved with or a member of: (ex: Boy Scouts, Neighborhood Watch Groups, Civic Clubs, Fraternal Organizations, etc. )*
3. Why do you wish to attend the Citizen Police Academy?
4. Have you ever been arrested and convicted of a felony crime, or under an indictment at this time? If so. explain:*
5. Have you ever been arrested and convicted of, or cited for a misdemeanor offense other than traffic fines of $500 or less? If yes, explain in detail indicating the date, charge, place and action taken.*
6. How did you hear about the Citizen Police Academy?
Drivers License and Social Security Numbers*
Your Drivers License and Social Security numbers must be on file before your application is acceptable.

Please wait 24 hours and call us at 281-422-5152 Monday through Friday, 8 am too 5 pm, with that information.
1. I acknowledge
Please review your answers carefully and read the statement below before submitting this application.*
I hereby certify that there are no willful misrepresentations, omissions, or falsifications in the foregoing statements and answers to questions. I understand that any omissions or false statements on this application shall be sufficient cause for rejection from the Baytown Police Department Citizen Police Academy. In consideration of my application to attend the Citizen Police Academy, I give the Baytown Police Department permission to check my personal background and to conduct other background checks as necessary to insure the integrity of the class.
1. I acknowledge
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Date Received:
Date Received:
Received by:
Drivers License Number:
Social Security Number:
Criminal History Check:
Texas DPS Number:
Fee paid:
Approved:
Academy Class Number:

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Email address

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Citizens Police Academy Application

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Additional Information

For Internal Use Only