Citizen Police Academy

Applicant Information

Your Name*

Date of Birth*

Street*

City*

State*

Zip Code*

Phone Number*

Email Address*

Employer Information

Employer's Name*

Employer's Phone Number

Date Hired

Employer's Street Address

Employer's City

Employer's State

Employer's Zip Code

Job Description

Driver's License Information

Driver's License Number

Driver's License State

Driver's License Expiration Date

Is Your Driver's License Valid?

Yes

Education Information

Education Level (check all that apply)

High School

College

Some College

Associate's Degree

Bachelor's Degree

Master's Degree

Doctorate

Other

Background Information

Have you ever been arrested or convicted of a crime or offense? (Select One):*

Yes

If yes, list date of conviction, state in which conviction occurred and final disposition:

Have you ever attended a Citizen's Academy presented by a Police Department?*

Yes

If yes, what city, state, or jurisdiction?

Please explain briefly why you wish to attend the Voorhees Police Department's Citizen Academy.*

Please list any associations, clubs, or organizations you belong to or are affiliated with.

Are there any medical or health conditions you feel The Voorhees Police Department Citizen Police Academy Staff should know?

Yes

If yes, explain:

Golf Shirt Size (Select One)*

References

Reference One

Reference One Name*

Reference One Relationship*

Reference One Address*

Reference One Phone Number*

Reference Two

Reference Two Name*

Reference Two Relationship*

Reference Two Address*

Reference Two Phone Number*

Certification

I certify that all statements made on this application are true and complete. I authorized any individual, company, organization, or institution to release any and all information concerning statements made by me on this application, and I do hereby release all parties and individuals connected therewith from all liabilities for any damages whatsoever incurred in furnishing such information. I agree and understand that any deliberate misstatement or omission of material facts may disqualify me from attending The Voorhees Police Department's Citizen Police Academy.

I further understand The Voorhess Police Department will be conducting a thorough background investigation which will include, but not limited to, any criminal history, employment history, and personal references.

My signature below acknowledges my understanding and agreement with the material provided.

Signature*

Today's Date*

News Release

For Immediate Release

Voorhees residents are invited to see what it’s like to be a police officer

The deadline for applications is Monday, February 23rd at 5:00 pm.