City of Brentwood, TN : Online Forms & Surveys

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Citizens Police Academy Application

PLEASE NOTE: The 2011 class is full. Applications submitted at this time will be kept for the 2012 class. Thank you.

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? *

Yes

10. Have you ever been convicted of a felony involving moral turpitude?*

Yes

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.*

Yes

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