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This information is necessary to complete backgrounds on our students and will be kept by the Support Services Commander or a designee for emergency contact.
I hereby certify that the information contained in this application is true and complete to the best of my knowledge. You are hereby authorized to make an investigation of my personal history deemed necessary for consideration to attend the Urbandale Citizen's Police Academy.
I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature. By typing my name above, I am electronically signing my application.
This field is not part of the form submission.
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