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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
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