Citizen Police Academy Application

Citizen Police Academy Application Form

CITIZENS POLICE ACADEMY APPLICATION

Application
Record Release
GCIC/NCIC History
Volunteer Waiver
Complete

Name:

Date of Birth:

Complete address:

Phone:

Email Address:

In case of emergency, please contact

Name:

Relationship:

Daytime phone:

Mobile phone:

Have you done volunteer work in the past?

If yes, please indicate what organization/type of work done

List your special skills, training, interests, languages, etc:

Gwinnett County will allow persons with disabilities to perform volunteer work. Are there any reasonable physical or structural accommodations that would be necessary for you to perform your volunteer duties?

If yes, please list type of accommodations

Type of volunteer activity you are interested in: (Check all that apply.)

Special Events Police

Office Assistance

Role Player for Training Exercises

You are required to disclose any and all arrests, even if you were a juvenile, sentenced under a first offender act, charged on a citation or ticket, released without charges, found innocent, or had your record sealed or expunged. All of these are shown on background checks performed, regardless of what you may have been told by an attorney or judge.

Have you ever been arrested?

Arrests Information

Police/Court Jurisdicition

Charge

Felony/Misdemeanor

Date

Disposition (dismissed, probation, jail time, fine, community service, etc)

2nd Arrest Information

Police/Court Jurisdicition

Charge

Felony/Misdemeanor

Date

Disposition (dismissed, probation, jail time, fine, community service, etc)

3rd Arrest Information

Police/Court Jurisdicition

Charge

Felony/Misdemeanor

Date

Disposition (dismissed, probation, jail time, fine, community service, etc)

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