THIS IS NOT AN APPLICATION TO BECOME A POLICE OFFICER OR FOR EMPLOYMENT AT THE RICHARDSON POLICE DEPARTMENT OR CITY OF RICHARDSON.

CITIZEN POLICE ACADEMY APPLICANTS: Please answer all questions, incomplete applications may not be processed. Please do not leave blank lines on the application, enter N/A or NONE where applicable. Applicants must live or work in the City of Richardson.

Please enter your full legal name as it appears on your Driver's License:

 *

Please enter your full legal name as it appears on your Driver's License:

First Name:

Middle Name:

Last Name:

Maiden name and/or any other names you have gone by:

Preferred Name or Nickname:

Sex:

Date of Birth (Please enter in this format, MM/DD/YYYY):

Texas Driver's License Number:

Home Address:

City:

Zip:

Home Phone:

Work Phone:

Cell Phone:

Email Address (For you to receive class information):

Work Information - Employer or Company Name:

Work Address:

City:

Zip:

Work Title or Position:

Retired? Yes or No:

What company did you retire from?

What was the last position held?

How many years of education completed?

Name, City and State of high school you attended:

Name, City and State of the College you attended:

Describe work responsibilities: 

Describe work responsibilities:

 Have you been arrested?

 *

Have you been arrested?

Yes

No

Short explanation of the arrest(s).
This includes deferred adjudication and expunged cases. Juvenile records not required:

 *

Short explanation of the arrest(s). This includes deferred adjudication and expunged cases. Juvenile records not required:

Short explanation of the arrest(s). This includes deferred adjudication and expunged cases. Juvenile records not required:

Organization(s) you belong to and position(s) held:

Are you an active member in any of the following? (select all that apply)

Are you an active member in any of the following? (select all that apply)

Crime Watch Patrol

Neighborhood Crime Watch

Home Owner's / Neighborhood Association

Volunteer at this police department

US Citizen?

US Citizen?

Yes

No

What country were you born in? (If not in the United States)

What country were you born in? (If not in the United States)

What country were you born in? (If not in the United States)

What year did you enter the United States?

Please tell us why you are interested in CPA. Elaborate including personal and work experience that would make you a good candidate. We recommend at least a paragraph.

At the conclusion of the course, do you have an interest in either of the following? (Check all that apply)

At the conclusion of the course, do you have an interest in either of the following? (Check all that apply)

Citizen's Police Academy Alumni Association (CPAAA)

Volunteer with the Richardson Police Department

BY SUBMITTING THIS APPLICATION, YOU CERTIFY THAT YOU UNDERSTAND AND GIVE YOUR FULL CONSENT TO THE RICHARDSON POLICE DEPARTMENT TO CONDUCT A CRIMINAL HISTORY CHECK. (THIS INFORMATION WILL BE KEPT CONFIDENTIAL AND IS NOT RELEASABLE TO THE PUBLIC.)

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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