[City of Gastonia] Citizens Police Academy Application

Today's Date

Please Write If You're Called By A Different Name

Home Phone Number

Work Phone Number

Current Employer

Occupation

Driver License Number

Have you ever been convicted of a crime?

Yes

If yes, explain briefly:

List 2 Personal References

Phone Number

Why do you want to attend the Gastonia Police Citizens Academy?

Any special considerations: handicapped, deaf/hard of hearing, language, allergies etc.

How did you hear about our Citizen’s Academy?