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2. Thank you for your interest in attending our Citizen's Police Academy.  All applicants must be at least eighteen (18) years of age.  Selection preferences will be given to Wilton Manors residents and those who work or own a business or property within the City.  This is your opportunity to become involved in a dynamic, rewarding partnership with your Police Department.  We need your participation to ensure the success of the Citizens Police Academy.  Don’t hesitate! Complete your application today. 

   A member of our team will contact you following our review of your application package.  Applicants will be notified whether or not they have been selected at least three (3) weeks prior to the start of class.  We look forward to seeing you!!!

4. * Indicates a Required Field
6. First Name*
7. Middle Name
8. Last Name*
10. Address1*
12. City*
13. State*
14. Zip*
16. Primary Phone Number*
17. Secondary Phone Number
19. Email*
20. Social Security # (Last 4-Digits)*
22. Driver License Number*
23. Driver License State*
25. Emergency Contact Name
26. Emergency Contact Relationship
28. Emergency Contact Phone Number
30. Have you ever been arrested?*

    1. Yes
    2. No
31. Have you ever been convicted of a crime?*

    1. Yes
    2. No
33. If you answered yes, clearly explain the circumstances of your arrest and/or conviction.
35. Have you or someone you know experienced a positive or negative encounter with law enforcement? Please explain.
37. How did you hear about the Citizen's Police Academy?
    -- Select One --City WebsiteSocial MediaFamily/FriendsFlyer/BrochureNetworking EventOther
39. What is your shirt size?*
    -- Select One --SmallMediumLargeX-Large2X-Large
41. Upload an image of your driver license, passport or other official form of government photo identification.*
43. Truth Verification and Certification*

    1. I Certify and Agree

    I certify that the information in this application is true, correct and complete to the best of my knowledge.  I also grant permission to the Wilton Manors Police Department to verify the information contained in this application and to review my criminal history and driving history.

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45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

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