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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> Starting in September, 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.
   
   Starting in September, 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

14. Time Commitment*

    If selected, you should be able to commit to attending all 10 sessions, 6:30-9 p.m. every Wednesday from Sept. 4 -Nov. 6, 2019. Can you commit to the Citizens' Police Academy schedule?

    1. Yes

    1. No

    1. Not Sure
16. If selected, you are expected to attend all 10 sessions, 6:30-9 p.m. every Wednesday from Sept. 4-Nov. 6, 2019. Participants cannot miss more than a maximum of two sessions. How many sessions do you commit to attending?*

20. Street Address*

22. City*

23. State*

24. Zip*

26. Email*

28. Primary Phone*

29. Secondary Phone

31. Emergency Contact Name*

32. Emergency Contact Phone*

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

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

40. Why are you interested in this program?*

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

44. How did you hear about our academy?*

46. 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

48. 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
50. Would you like to subscribe to Issaquah Insider, our weekly e-newsletter?

    1. Yes
    2. No

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52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

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