Sedgwick County, Kansas...working for you

Sedgwick County...working for you
Sedgwick County, Kansas

525 N. Main  ●   Wichita, KS 67203  ●   Tel: (316) 660-9000
www.sedgwickcounty.org

Citizen Police Academy

Application to Attend

Personal Information

Name:    
Age:    Race:   Sex: Male Female 
Date of Birth (mm-dd-yy): 
Driver License Number (including state): 
Address:   
City:    Zip Code: 
Home Phone:   email:

Are you related to a Sheriff's Deputy or Police Officer? Yes No

Employment Information

Occupation: 
Business Name: 
Business Address:  
Business Phone: 

Other Information

Please list the names of community groups you are affiliated with.
 

Why do you wish to attend the Citizen Police Academy?
 

How did you hear about the Citizen Police Academy?
 

References

Please provide two references:  

Reference One Name: 
Address: 
Phone Number: 

Reference Two Name: 
Address: 
Phone Number: