2009 Citizens’ Police Academy

 

      Application for Enrollment

 

You must be at least 21 years old and work or reside within the Ypsilanti area.

 

The Ypsilanti Police Department will conduct a background check on all applicants.

You understand and agree that the department reserves the right to deny entry to the Academy

based on the findings of the background check.

 

Please print this form, legibly complete it, and send it to the address below.

 

 

Name:________________________________________ Date of Birth:_______________

 

Address:________________________________________________________________

 

City:____________________________________ State:_______ Zip Code:___________

 

Home Phone:________________________ Business Phone:_______________________

 

Employer:_________________________________ Position:______________________

 

Email Address:__________________________ Ops. License#:_____________________

 

Community / Group Affiliations:

 

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

 

Please write a short paragraph stating why you would like to attend the Citizens’ Police Academy.  Attach

an additional sheet, if needed.  You must include this to be considered.

 

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

 

I certify the above information is true and I waive any privilege.

 

_____________________                              ____________________________________

Date                                                                 Applicant's Signature

 

Please mail the completed application to:

 

Citizens' Police Academy

Ypsilanti Police Department

Attn:  Sgt. Kevin Dorsey

505 West Michigan Avenue

Ypsilanti, MI  48197 

For more information call:  ( 734 ) 483-9510
or send e-mail to kdorsey@cityofypsilanti.com