2. 
3. 2022 Spring Hill Police Department

   CITIZEN'S POLICE ACADEMY APPLICATION

4. 
6. Date submitted*
   Date submitted
8. First Name*
9. Last Name*
11. Address1*
13. City*
14. State*
15. Zip*
17. Date of birth*
    Date of birth
18. Drivers License number/state*
20. Best contact phone number: *
21. Email:
23. Do you have a handgun carry permit?*
    -- Select One --YesNo
24. What is your shirt size?*
    -- Select One --XSSMLXLXXLXXL
28. EMPLOYMENT
30. Employer*
31. Position
33. Street Address
34. City
35. State/Zipcode
39. CRIMINAL HISTORY
41. Have you ever been convicted of a felony?*
    -- Select One --Yes (please answer questions A-C)No
43. a. Date of conviction
    a. Date of conviction
44. b. Charge(s)
45. c. City/State
47. Have you ever been convicted of a misdemeanor?*
    -- Select One --Yes (answer questions a-c)No
49. a. Date of conviction
    a. Date of conviction
50. b. Charge(s)
51. c. City/State
55. REFERENCES

    Please provide the name and phone number of two character references.

57. Reference 1.*
58. Phone number*
60. Reference 2.*
61. Phone number*
65. GENERAL
67. Why do you wish to attend the Citizen’s Police Academy? *

69. By signing below, I certify that all statements made on this application are accurate and Spring Hill Police Department has my consent to conduct a basic background investigation prior to admittance into the program.

71. Name:*
72. Date:*
    Date:

74. THIS IS NOT AN EMPLOYMENT APPLICATION

Leave This Blank:


76. 1. Receive an email copy of this form.
77. Email address

    This field is not part of the form submission.

78. Submit Submit and Print

* indicates a required field