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CITIZEN POLICE ACADEMY APPLICATION

2. Last Name

3. First Name

4. Middle Initial

6. Address

8. City

9. State

10. Zip Code

12. Driver's License Number

13. Date of Birth

14. Choose one

    1. Male
    2. Female

16. Phone Number

17. Email Address

19. Employer

21. Business Address

23. City

24. State

25. Zip Code

27. Your Title / Position

29. Community Group Affiliation(s) - if any

31. I authorize the Elgin Police Department to conduct a background investigation for criminal history for the purpose of making a determination of eligibility for the Citizen Police Academy.

    I understand that typing my name is my electronic signature and authorization to complete my application.

33. Date
    Date

35. If you would prefer, you may print this form and submit it to the Elgin Police Department.
    Mail or deliver to: Elgin Police Department - 202 Depot Street, Elgin, TX 78621

    Mail or deliver to: Elgin Police Department - 202 Depot Street, Elgin, TX 78621

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field