Citizens Academy Application – CHRISTIAN COUNTY SHERIFF’S OFFICE

Contact Information – Step 1 of 4

Today's Date *

I have read, understand, and acknowledge the Terms of Use. To view Terms of Use, please visit the Christian County Sheriff’s Office website.

Applicant's Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Shirt Size (for Citizens' Academy shirt) *

How long have you lived or owned property in Christian County?

Please share with us why you would like to participate and what you hope to learn from the Citizen's Academy?

How did you hear about Citizens' Academy? *

Are you willing and able to attend a minimum of three (3) of the four (4) sessions? *

Occupation

Employer

Date of Birth *

Driver's License Number *

Gender *

Male
Female

Do you have any past arrests, convictions, or pending court cases? (Include all misdemeanors and felonies. You do not have to include traffic citations.) *

If you answered ‘yes’ to the above question, please list the date, agency, charge, and disposition in the area below.

Background Authorization: I understand a criminal background and warrant check will be conducted by the Christian County Sheriff’s Office as part of the application process. I hereby authorize any law enforcement agency to release to the Christian County Sheriff’s Office any and all information, which any said agencies have about me, for the limited purpose of aiding the Christian County Sheriff’s Office in evaluating my eligibility for participation in the Citizen’s Academy. This authorization extends to any agency information about me, whether public, personal or confidential. I understand that I am not entitled and I will not receive the contents of the confidential reports received from any agency. I hereby release, discharge and agree to hold harmless the agencies, their agents and any person furnishing the information, from any and all liability arising out of furnishing and inspecting such documents and information. *

I agree
I decline

Signature *

Applications cannot be processed without a signature. A printed signature form is available at the Sheriff’s Office.

Single Line Text