FRESNO POLICE DEPARTMENT 

CITIZENS’ POLICE ACADEMY ENROLLMENT APPLICATION


Name:_____________________________________________________________________________________________
                                                 (Last)                                                                        (First)                                                                   (Middle)

Address:___________________________________________________________________________________________
	(Street)                                                      (City)	                                                (State)                             (Zip Code)

Home Phone:_____________________________________ Work Phone:________________________________________ 


E-mail address:__________________________________________________________  Cell/alt:_____________________


Occupation:________________________________________________________   Date of Birth:_____________________


California Drivers License Number:__________________________________________   Expires: ____________________


Please describe your current civic/community involvement:____________________________________________________

___________________________________________________________________________________________________
(Use an additional page, if needed.)


Candidates for the Citizen’s Police Academy must be: At least 18 years of age, live or work in the Fresno area, have no felony convictions, no misdemeanor convictions in the last 12 months, and not be on parole or probation.  Acceptance into the course is at the sole discretion of the Fresno Police Department (FPD).  
There is a $20.00 fee for course materials.  Check payable to FPNWA-CPA must accompany this application.
Your signature on this form authorizes the FPD to perform a records check for purposes of admission to the CPA. 

Applicant Signature:_________________________________________________  Date:_____________________



FOR CPA OFFICE USE ONLY 

Course Start Date_______________________   Background:__________________  Enrollment Fee:__________________







RETURN FORM TO CSO LINDSAY HUGHES – CITIZEN’S POLICE ACADEMY
Fresno Police Department  - 2326 Fresno Street - Fresno, California  93721
(559) 621-2113 – FAX (559) 498-1095