Citizens Police Academy Application

Background
Are you a resident of the City of Bethlehem?
How long have you been a resident?
Do you own a business or work in the City of Bethlehem?
How long have you worked in Bethlehem?
Name of Business
Have you ever been arrested for, convicted of, or cited for an offense other than traffic fines of $200 or less?
Please explain in detail, listing appropriate dates, charges, places, and action taken:
Please explain briefly why you wish to be enrolled in the Citizens Police Academy (CPA):
How did you hear about the CPA?

Employment
Present Employer
Present Employer Address

Street Address

Street Address Line 2

CityState

Zip Code
Present Employer Phone Number
Please enter a valid phone number.Format: 000-000-0000.
Your Position or Title with Your Present Employer
Your Supervisor's Name

I hereby certify that there are no willful misrepresentations, omissions, or falsifications in the foregoing statements and answers to questions. I understand that any omissions or false statements on this application shall be sufficient cause for rejection for enrollment or dismissal from the City of Bethlehem Citizens Police Academy. I further understand that the City of Bethlehem Police Department will be conducting a thorough background investigation that may indude, but not limited to, any criminal history, employment history and personal references.
Signature
Please verify that you are human
Should be Empty:

Background