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Inglewood Police Community Academy Application
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This form has been modified since it was saved. Please review all fields before submitting.
First
*
Last
*
Address
*
Date of Birth
*
City
*
State
*
Zip Code
*
Employer
*
Job Title
*
Employer Address
*
Email Address
*
Home Phone
*
Work Phone
*
Cell Phone
*
Driver's License #
*
State
*
Expiration Date
How did you learn about the Community Policy Academy?
*
Why are you interested in attending the Community Police Academy?
*
What do you wish to obtain from attending the Community Police Academy?
*
What are some issues/concerns related to law enforcement you would like to discuss?
*
List the area/areas you would like law enforcement to improve.
*
Your past contacts, if any, with law enforcement have been:
*
Positive
Negative
None
After participating in the Community Police Academy, would you encourage others to attend? Why or why not?
*
Consent
*
I consent to a record check to determine eligibility for admittance into the Inglewood Police Department Community Police Academy. If accepted as a student, I agree to abide by all the rules and regulations and refrain from being absent more than once during the ten-week class schedule. Persons selected to attend will be notified by email and/or phone at least two weeks prior to the beginning of class.
I agree
Electronic Signature Agreement
*
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
I agree.
Electronic Signature
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