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Citizens Police Academy Spring Application

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Steps

1. Step One This section is complete This section is incomplete
2. Citizen Police Academy Application This section is complete This section is incomplete
3. Employment Information This section is complete This section is incomplete
4. Education This section is complete This section is incomplete
5. Community Activities This section is complete This section is incomplete
6. Law Enforcement Contact This section is complete This section is incomplete
7. References This section is complete This section is incomplete
8. Acknowledgement and Signature This section is complete This section is incomplete

Step One

Spring CPA Class
The Princeton Police Department sponsors the Citizens Police Academy (CPA) with the goal of educating the residents of Princeton on the operations of the department. This is accomplished through a series of lectures and hands-on activities on Thursday evenings from 7 to 10 pm for 12 weeks.
Classes are from March 9^th – June 1^st. Attendees are required to attend 10 out of the 13 to be able to graduate.
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Citizen Police Academy Application

First Name*
Last Name*
Phone Number*
Email Address
Date of Birth*
Driver's License Number
State
Are you a Texas License to Carry holder?*
1. Yes
2. No
How did you learn of the Citizens Police Academy?
Why are you interested in the Citizens Police Academy?
Will you commit to attend all class sessions?
1. Yes
2. No
What is Your T-Shirt Size?*
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Employment Information

Occupation
Length of Employment
Company Name
Email Address
Employer Address
City
State
Zip Code
Work Number
Supervisor’s Name
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Education

Are you a high school graduate?*
1. Yes
2. No
Name and address of high school: *
Are you a college graduate?
1. Yes
2. No
Name and address of college:
Last grade completed:
1. 10
2. 11
3. 12
4. AA
5. BS/BA
6. MS/MA/MBA
7. Ph.D.
8. M.D
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Community Activities

List all community organizations in which you have been or are currently involved. Include leadership positions:
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Law Enforcement Contact

Have you ever been arrested?*
1. Yes
2. No
If yes, give details including offense, date of arrest and disposition of your case(s)
My prior contacts with the police have been:
1. Good
2. Bad
Please explain:
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References

List a person 18 or older to be contacted in case of emergency (REQUIRED):
Name*
Email Address
Address*
City*
State*
Zip Code*
Phone Number*
List two personal references other than family members:
Name
Email Address
Address
City
State
Zip Code
Phone Number
Name
Email Address
Address
City
State
Zip Code
Phone Number
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Acknowledgement and Signature

Please review your answers carefully and read the following statements before signing this application. Incomplete or unsigned applications will not be accepted.
I further understand and hereby authorize the Princeton Police Department to make any investigation of my personal history deemed necessary for consideration to attend the Citizens Police Academy. I understand that this background investigation may include, but is not limited to criminal history, employment history, and personal references.*
1. Yes
2. No
I certify that there are no willful misrepresentations, omissions or falsifications in the foregoing statements or answers. I understand that any omissions or false statements on this application shall be sufficient cause for rejection or dismissal from the Princeton Citizens Police Academy after enrollment. *
1. Yes
2. No
I understand that if I am a Texas Concealed Handgun License holder or become licensed during the course of the academy, I will not carry any weapon(s) into class or to any Citizens Police Academy or Citizens Police Academy Alumni Association function. I understand that to do so is cause for immediate dismissal from the program.*
1. Yes
2. No
I further state that I have never been convicted of any violent felony offense, family violence assault; narcotics violation, or weapons offense, nor have I been convicted of any Class B or higher misdemeanor or non-violent felony offense within the past 10 years. I further attest that I am not currently under indictment for any offense nor do I knowingly associate with any individuals whom I believe to be convicted of, under investigation or indictment for any felony, not excluding narcotics, weapons, or assault offenses, by any law enforcement agency. I understand that I may be dismissed from the Academy if my behavior is deemed to be disruptive or if it otherwise inhibits the concept of this Citizens Police Academy program. *
1. Yes
2. No
I, the undersigned ______________________________, a private person, for and in consideration of the privilege of participating in the Princeton Citizens Police Academy, and recognizing that such activity involves certain inherent dangers do hereby agree to assume the risks attendant to such activity, to include motor vehicle accidents on either public streets or private property, and do hereby release the City of Princeton, its officers, agents, representatives and employees, in both their public and private capacities, from any and all liability claims, suits, demands, damages, including attorneys’ fees, or causes of action, for any and all claims, personal injury or property damage, that I, or my heirs, successors and assigns may have or may hereafter acquire against the City of Princeton, including but not limited to: 1) motor vehicle accidents on public streets or private property; 2) personal injury or property damage that may arise from the acts of a third person; 3) personal injury or property damage that may arise from the negligent acts of the City of Princeton, its officers, agents, representatives, or employees relative to my participation in the Princeton Police Department Citizens Police Academy; and /or 4) wrongful death claims. *
1. Yes
2. No
It is further agreed that the execution of the release shall not constitute a waiver by the City of Princeton of the defense of governmental immunity. *
1. Yes
2. No
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.
1. I agree.
Electronic Signature*

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