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2. First Name
3. Last Name
5. Address1
7. City
8. State
9. Zip
11. Date of Birth
12. Email
14. Drivers License Number
15. Phone Number
16. Occupation
18. Why do you wish to attend the Citizens Police Academy?
20. List two references with phone numbers
22. Electronic Signature Agreement

    1. I agree.

    I authorize the Fayetteville Police Department to conduct a background investigation to obtain any information relating to my criminal history for the purpose of making a determination of my eligibility for the Citizen’s Police Academy.
24. Electronic Signature
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26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field