Youth Academy Application – CHRISTIAN COUNTY SHERIFF’S OFFICE

Today's Date *

Terms of Use *

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

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Date of Birth *

Gender *

Name of School *

Current Grade *

School Phone Number *

T-Shirt Size *

Has the applicant ever been arrested for OR charged with Juvenile Delinquency? If yes, please explain.

Has the applicant ever received a summons, been charged with, or been arrested for any criminal act? If yes, please explain. *

Utilize the space below to explain why you would like to participate in CCSO Youth Academy: *

Parents or Custodians *

Parents or Custodians Contact Number *

Parent Signature *

Clear Signature

Youth Signature *

Clear Signature