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Survey/Form Review
Citizens Police Academy Application
We are now accepting applications for the 2017 class, which will run from March to May 2017 (specific start/end dates TBA). Classes are generally from 6:00 p.m. to 9:00 p.m., but several evenings will run as late as 10:00 p.m.
1. Name:

2. Date of birth: (mm/dd/yyyy)

3. Address:

4. List any other addresses you have resided at in the City of Brentwood

5. E-mail address:

6. Home Phone:

7. Business Phone:

8. Reason for requesting to participate in program:

9. Have you ever been convicted of a felony? *
10. Have you ever been convicted of a felony involving moral turpitude?*
11. I am willing to undergo a minimum background investigation by the City of Brentwood Police Department due to the sensitivity and nature of some of the information that will be covered during the course of training.*
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