Johns Creek Citizens Police Academy

Phone Number

GA Driver's License Number

Expiration Date (mm/dd/yyyy)

Date of Birth (mm/dd/yyyy)

SSN

T-shirt size (Men)

XXL

T-shirt size (Women)

XXL

In Emergency Notify

Relationship

Phone Number

Have you ever been arrested? If yes, please describe

Describe briefly why you are interested in attending the Citizens Police Academy

Have you ever had any contact with the JCPD? If so, briefly explain

Please upload a copy of your Georgia Drivers’ License (or government issued photo ID)

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By submitting this application, you (the applicant) hereby certify that there are no willful misrepresentations, omissions, or falsifications in the following statements and answers to questions. You (the applicant) understand that any omission or false statements on this application shall be sufficient cause for rejection for enrollment or dismissal from the JCPD Citizens Police Academy.

You (the applicant) understand that, if selected for enrollment, you will pledge the time commitment to attend all Academy classes. You (the applicant) further understand that the JCPD Citizens Police Academy will be conducting a background investigation that may include, but not be limited to, any criminal history, driving record, and/or other personal references.

This class will be filled based on the order in which the completed applications are received.

Your signature (the applicant) below certifies that you (the applicant) have read and understand these completed pages, and agree to the terms and conditions outlined in this document.

If you would like to submit a paper copy of this application and a paper copy of your driver's license, you can download the paper form here and bring it with you to Johns Creek Police Department Headquarters, 11360 Lakefield Drive, Johns Creek, GA 30097.

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

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