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Citizens Police Academy On-line Application

TITUSVILLE POLICE DEPARTMENT
CITIZEN POLICE ACADEMY APPLICATION 

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*Must be 18 years of age or older.
*Must pass a minimum background check.

The following information is required because all attendees must sign a confidentiality oath and undergo a background check as part of the application process.

Please fill in all sections of the application.  You will be contacted by a member of the Titusville Police Department within three days after receiving the application.

 
* Application Date 
* First Name
 
* Last Name
 
* Phone Number
 
* Home address
 
* City
 
* State
 
* Zip Code
 
* Date of Birth
 
* Place of Birth (City / State) 
Excellent Good Fair Poor 
* Physical Condition
Why do you wish to attend the Citizen Police Academy?
 
* Drivers License or Identification Number
 
* Drivers License or ID State
 
* Have you ever been arrested / convicted of a crime? If Yes, please describe: 
* Please give the name, address and phone number of two character references: 
 

By submitting this form you affirm all information supplied is true and correct.  You also acknowledge that the Titusville Police Department will use this information for the purpose of completing a criminal background check.

 
Email Disclaimer: Under Florida law, email addresses are public records. If you do not want your email address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.
P. O. Box 2806, (32781-2806) - 555 S. Washington Avenue - Titusville, FL 32796 - Phone: (321) 567-3775 - Fax: (321) 383-5704 - Site by Project A