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Citizens Police Academy Application

  1. Sex*
  2. Have you ever been arrested for any offense other than a simple misdemeanor?*
  3. Will you be able to commit to 10 out of the 12 class sessions?*
  4. Polo Shirt Size*
  5. Please read the following:
    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.
  6. 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.
  7. Leave This Blank:

  8. This field is not part of the form submission.