2. Personal Identifiers:
4. First Name
5. Middle Initial:
6. Last Name
8. Alias Names:
10. Date of Birth:
11. Gender:
13. Texas Driver License Number:
15. Home Information:
17. Address
19. City
20. State
21. Zip
23. Home Phone:
24. Work Phone:
25. Cell Phone:
27. E-mail address:
29. Work Information:
31. Occupation
32. Length of Employment
34. Employer/Business Name:
36. Address
38. City
39. State
40. Zip
42. Community Activities: List all community organizations in which you have been or are currently involved. Include leadership positions.
44. Please explain briefly why you want to attend the Citizens Police Academy.
46. Background Information:

    Prior to acceptance, a background investigation will be done on all applicants. The background will include prior criminal offenses. A prior conviction will not automatically disqualify an applicant. Each applicant's situation will be considered as it relates to the Academy.

48. My prior contacts with the police have been:

    1. Good
    2. Bad
50. Please eplain:
52. Have you ever been arrested?

    1. Yes
    2. No
54. If yes, give details including offense, date of arrest and disposition of your case.
56. References

    Because of the nature of information presented in the academy, we ask for personal references in order to complete the investigation into an applicant's background.

58. Reference 1:
60. First Name
61. Last Name
63. Address
65. City
66. State
67. Zip
69. Home Phone:
70. Cell Phone:
71. Email:
73. Reference 2:
75. First Name
76. Last Name
78. Address
80. City
81. State
82. Zip
84. Home Phone:
85. Cell Phone:
86. Email:
88. Certification and Signature

    I hereby certify that there are no willful misrepresentations, omissions or falsifications in the foregoing statements and answers to questions. I understand that any omission or false statement on this application shall be sufficient cause for rejection of enrollments or dismissal from the Sachse Citizens Police Academy. I understand that participation in this program is not to train students to be police officers. Participation is to provide education regarding the purpose, rationale and context of police procedures. I acknowledge that as part of acceptance in this program, I will abide by all rules and regulations set forth by the Sachse Police Department and the City of Sachse and will provide my own transportation and insurance. I further understand that the Sachse Police Department will conduct a thorough background investigation that my include criminal history information, employment history and personal reference.  The Sachse Police Department reserves the right to deny any applicant. 

90. DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

92. Applicant's Signature
93. Date:
Leave This Blank:


95. Submit

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