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HomeMy WebLinkAboutCPA ApplicationJohnson County Citizens Police Academy 2019 Application Hosted by the Coralville Police Department, Iowa City Police Department, Johnson County Sheriff’s Office, North Liberty Police Department and the University of Iowa Police Department Please type or print legibly in blue or black ink. Name: Address: First Middle Last Street Phone: City Stat e Zip Code Cell/Home W ork Date of Birth: Email: Driver’s License Number & State: Employer: Occupation: Employer’s Address: Street City State Zip Code Have you been arrested for any offense other than a traffic violation? Yes No If yes, w hat for? When? Where? Are you able to attend six or more sessions? Yes No Why do you w ant to attend the Citizen’s Police Academy? What shirt size do you w ear? S M L XL XXL XXXL A $25.00 participation fee is required to cover the costs of materials and supplies. Please attach payment to this application. Make checks payable to the Citizen’s Police Academy. I hereby certify that the information in this application is true and complete to the best of my knowledge. You are authorized to make any investigation of my personal history deemed necessary of consideration to attend the Citizen’s Police Academy. Johnson County Citizens Police Academy 2019 Application Applicant signature Date Johnson County Citizens Police Academy 2019 Academy Participant Instructions Hosted by the Coralville Police Department, Iowa City Police Department, Johnson County Sheriff’s Office, North Liberty Police Department and the University of Iowa Police Department 1. The Citizen’s Police Academy shall not interf er e with routine operations of any law enf orcem ent agency. 2. During ride along activities, participants will follow all instructions given by the off icer. No interf erence with the performance of any off icer shall be permitted. 3. The student shall not be arm ed at any time. 4. Participants who are asked to ident if y themselves should explain that they are a Citizen’s Police Academy participant. 5. SMOKING IS NOT ALLOWED in any governm ent building or v ehicle. 6. A criminal records check will be conducted on all applicants prior to acceptance into the Academ y. 7. All participants will conduct them selves in an appropriate and prof essional manner. 8. Violation of any instruction, g uideline, rule or failure to comply with a reasonable request will term inate the citizen’s participation in the Academy. This is at the discretion of any member of the Coralville, Iowa City, North Liberty, or University Police Departments, or Johnson County Sheriff’s Office. 9. The maximum number of tim es a participant can attend the Citizen’s Police Academ y is two. 10. The maximum number of times a participant can m iss class is 3 times, total during the academy. 11. All applicants must be at least 16 years of age by January 21st, 2019. In consideration of the above law enforcement agencies granting permission to enter in or upon any premises or vehicles which are under their actual care or constructive or passive control, I hereby waive all claims to damage or loss to my person or property which may be caused by any act, or failure to act, of the Coralville, Iowa City, North Liberty and/or University Police Departments, and/or Johnson County Sheriff’s Office officers, agents or empl oyees. I assume the risk of all dangerous conditions in, upon or about the premises or vehicles and waive any and all notice or existence of such conditions. I certify that I understand the requirements and responsibilities of partic ipants in this program. Applicant signature Date Please mail or hand-deliver completed applications to the Coralville Police Department, Iowa City P olice Department, Johnson Count y Sheriff’s Office, North Liberty Police Department or the University of Iowa Police Department. Applications must be received by 5pm on January 21, 2019 to be considered for the 2019 Aca demy.