<p> LINTON POLICE DEPARTMENT</p><p>Citizen’s Academy Application</p><p>This document contains questions necessary to determine who would be best fitted to participate in the Linton Police Departments Citizen’s Academy. 1 | P a g e Linton Police Department Citizens Academy Application Form</p><p>Name:______DOB:______(First) ( Middle) (Last)</p><p>Drivers License #: ______</p><p>Address: ______</p><p>Phone:______Cell Phone:______</p><p>Who do you want contacted in case of an emergency: ______</p><p>Relationship: ______</p><p>Have you ever been convicted of a criminal offense: Yes No : If yes explain attach a separate piece of paper if necessary. ______</p><p>What inspired you to want to attend this training? ______</p><p>What do you expect to gain from attending the Citizens Academy? ______</p><p>2 | P a g e Are you willing to dedicate your time for at least two hours a week for up to 10 weeks to complete this training? Yes No</p><p>Do you have any prior training in the Law Enforcement area? (note: prior training is not a requirement) Yes No Explain: ______</p><p>Have you ever had any dealings with Law Enforcement such as been a victim of a crime, accused of committing a crime, and or been a witness to a crime that had been reported to the police? Yes No If so what was your impression of the law enforcement personnel whom you dealt with? ______</p><p>Part of this training is class room other parts may be riding in a patrol car. Do you have any conditions you are aware of that would be damaging to your mental or physical health by flashing lights, sirens, exceeding posted speed limits, arriving to an accident scene that involves personal injury or other related type scenes? Yes No If yes please explain: ______</p><p>Confidentiality:</p><p>The Linton Police Department works numerous cases a month. Sometimes information that is reported in these cases is personal or trusted information. Being a small community chances are good that you may witness or view material of a case dealing with someone you know. Regardless of whether you are familiar with someone involved in a case or not can you be trusted not to speak openly in public about these cases? Yes or No </p><p>3 | P a g e 4 | P a g e</p>