Citizen's Police Academy Application Form

2. The next Citizen's Police Academy will be annonunced.
   By completing the following information below, I understand that I am making an application to attend the Citizen's Police Academy sponsored by the Mount Pleasant Police Department. As an applicant to attend the academy. I understand the police department may conduct a minimal background check for criminal history. The information provided will be kept strictly confidential and will be destroyed at the end of the academy or as soon as possible if I am denied attendance.

   By completing the following information below, I understand that I am making an application to attend the Citizen's Police Academy sponsored by the Mount Pleasant Police Department. As an applicant to attend the academy. I understand the police department may conduct a minimal background check for criminal history. The information provided will be kept strictly confidential and will be destroyed at the end of the academy or as soon as possible if I am denied attendance.

4. First Name*

5. Middle Name

6. Last Name*

8. Home Address*

10. City, State, Zip Code*

12. Phone Number*

13. Work Number

14. Date of Birth*

16. Drivers License Number *

17. Drivers License State*

18. Email *

20. Mount Pleasant City Resident

    1. yes
    2. no

21. Employeed in Mount Pleasant?

    1. yes
    2. no

22. Attended a previous citizen academy?

    1. yes
    2. no

23. Have you ever been convicted of a felony?

    1. yes
    2. no

25. By submitting the form and printing your name you agree to the following:
    I, the undersigned, as an applicant to the Citizen's Police Academy, agree to allow the police department to run a minimal background check on me. If selected, I also agree to attend as many of the class sessions as possible and understand that attendance and graduation from the academy does not qualify me to be or act as a peace officer in the State of Texas. The police department has the right to accept or reject my application for any reason.

    I, the undersigned, as an applicant to the Citizen's Police Academy, agree to allow the police department to run a minimal background check on me. If selected, I also agree to attend as many of the class sessions as possible and understand that attendance and graduation from the academy does not qualify me to be or act as a peace officer in the State of Texas. The police department has the right to accept or reject my application for any reason.

27. Print Name

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field