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Citizens’ Police Academy Application

2. Welcome
   Meet the men and women who serve and protect you every day, ride along with a police officer and become a more informed citizen.<br><br> Periodically, our police department will hold a free 10-week Citizens' Police Academy for adults 21 and older who live or work in Issaquah. If selected, you should be able to commit to attending all 10 sessions.

   Meet the men and women who serve and protect you every day, ride along with a police officer and become a more informed citizen.
   
   Periodically, our police department will hold a free 10-week Citizens' Police Academy for adults 21 and older who live or work in Issaquah. If selected, you should be able to commit to attending all 10 sessions.

6. First Name*

7. Middle Name*

9. Last Name*

11. Date of Birth*
    Date of Birth

12. Are you 21 or older? *
    -- Select One --YesNo

16. Street Address*

18. City*

19. State*

20. Zip*

22. Email*

24. Primary Phone*

25. Secondary Phone

27. Emergency Contact Name*

28. Emergency Contact Phone*

32. What is your connection to Issaquah?*
    -- Select One --Live hereWork hereOther

34. Do you have a valid Washington state drivers license?*
    -- Select One --YesNo

36. Why are you interested in this program?*

38. What areas of law enforcement are you interested in hearing more about?*

40. How did you hear about our academy?*

42. Preference will be given to applicants who live or work in Issaquah. If enrollment is full this session, would you like us to keep your application on file to be included in the next session?*
    -- Select One --YesNo

44. The Issaquah Police Department will run a criminal records check on all applicants. A record of criminal convictions or adverse police contacts could preclude your acceptance into the program. Clicking "Yes" below authorizes this procedure.*

    1. Yes
46. Would you like to subscribe to Issaquah Insider, our weekly e-newsletter?

    1. Yes
    2. No

Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field