130 Pearl Street | Springfield, MA 01105
Non-Emergency: 413-787-6300
clerks-office@springfieldpolice.net
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Citizens Police Academy Application
Name
*
Street Address
*
Address Line 2
City
*
State
*
Zip Code
Date of Birth
mm/dd/yyyy
License or ID number
Telephone number (Day)
Telephone number (Evening)
*
Email address
*
Are you a member of a Beat Management Team?
*
Yes
No
Are you a member of a neighborhood council or civic association?
*
Yes
No
Are you a member of a Crime Watch?
*
Yes
No
List any other relevant organizations you belong to, if any.
How did you learn about this class?
Consent
I am submitting my name for consideration for admission to the Citizen's Police Academy. I understand that a record check will be conducted. I understand this is an educational opportunity.
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