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Community Police Academy Form

  1. Application Information
  2. Employment Information
  3. Emergency Contact:
  4. How did you hear about the academy? ( Select all that apply)
  5. Criminal History
  6. Have you every been charged and/or convicted of a crime? *
  7. Please List Information:
  8. Medical Information (Optional)
  9. Hospital Preference
  10. Consent:
    I certify that the information in this application is true and complete to the best of my knowledge. I also grant permission for the Durham Police Department to verify the above information contained on this application and check for prior criminal history. My initials below acknowledge that the above information is true and correct to the best of my knowledge.
  11. Leave This Blank:

  12. This field is not part of the form submission.