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CITIZEN’S POLICE ACADEMY APPLICATION

Email Address*

First Name*

Middle Name (optional)

Last Name*

Street Number & Name*

City*

State*

Zip Code*

Business Name (if applicable)

Business Address (if applicable)

Home Phone

Cell Phone*

Business Phone

Occupation*

Job Title*

Drivers License Number*

Date of birth

Referred By

Have you ever been arrested for any offense other than a traffic violation?*
Yes No

(if yes, state where, when, and describe the circumstances.)

Describe in your own words why you want to be in the Citizen's Police Academy.*

I hereby authorize the La Grange Police Department to make an examination of their records for the purpose of evaluation by application.*
Yes No

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Website by Alberto Garcia
©2019 LaGrangeCPAAA.org - All rights reserved
Website by Alberto Garcia

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