Citizen Police Academy Application "*" indicates required fields Name* First Last Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth* MM slash DD slash YYYY Have you ever been known by another name?* Yes No If yes, what names?*Have you ever lived in any other state?* Yes No If yes, where and how long?*Current occupation*Current Employer(s)*Reasons for attending the Citizens Police Academy*Are you related to anyone in law enforcement?* Yes No If yes, who and where are they employed?*Have you ever had any contact with a member of the Bridgewater Police Department, or any other local, state or federal agency for any reason including a ttraffic stop, to report criminal activity, call for assistance, etc?* Yes No If yes, please explain.*Have you ever been convicted of a crime? (Felony or Misdemeanor)* Yes No If yes, please explain.*Have you ever been taken into custody by a law enforcement officer for any reason?* Yes No If yes, please explain.*Have you ever been arrested, charged, or been suspect in a crime?* Yes No If yes, please explain.* Δ
