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2. Instructions
   • Incomplete applications will not be accepted.
   • Applicants must be at least 18 years of age.
   • A criminal history check will be conducted on each applicant. No applicants that have ever been convicted of a felony offense or have been arrested for a misdemeanor offense within the past year will be considered.
   • Participants are required to conduct themselves in a professional manner at all times. Failure to do so may result in dismissal from the academy.
   • Accepted participants will be notified of the class dates. Class size is limited to approximately 16 students and Colerain residents will be given first consideration.
4. First Name*
5. Last Name*
7. Place of Employment
9. Email Address
11. Home Phone*
12. Work Phone
14. Address*
16. City*
17. State*
18. Zip Code*
20. Date of Birth*
    Date of Birth
21. Shirt Size*

    1. Small
    2. Medium
    3. Large

    1. Extra Large
    2. 2XL
    3. 3XL
23. Special Accommodations Needed?
25. Why do you want to attend the Police Academy?*
27. Signature*

    By checking the "I agree" box below, you agree and acknowledge that:

    1. 1.) Your application will not be signed in the sense of a traditional paper document
    2. 2.) By signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature
    3. 3.) You may still be required to provide a traditional signature at a later date.

    
    

    1. I Agree - Electronic Signature
28. Today's Date*
    Today's Date
30. Signature*
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field