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2. Bristol TN Police Department

   Citizen's Police Academy
   
   In order to enhance and develop citizen awareness and understanding of the police role in the community, the Bristol Tennessee Police Department has developed a Citizen's Police Academy. This "new" concept in law enforcement is designed for citizens of different backgrounds and occupations. 

   This program consist of (27) hours of police training with a majority of the instruction being "hands-on". Training areas covered include traffic stops, criminal investigation procedures, firearms and self defense instruction, accident investigation, narcotics and vice investigation, domestic violence and D.U.I. enforcement. In addition, students are required to ride for two (2) shifts on patrol with a certified officer. 

   The objective is not to make the "graduates" of the course police officers, but better informed citizens with a greater general knowledge of our many functions. We also hope to foster enhanced community relations through these graduates and the people they touch in every day life. 

4. REQUIREMENTS AND LIMITATIONS

   Citizens applying for the Citizens Police Academy must adhere to the following standards:

   1. Must be 18 years of age or older. 

   2. No criminal history other than minor traffic violations. 

   3. Physically able to meet training requirements. 

   4. Must attend one night per week (3 hours per night) for 9 weeks. 

   5. Must ride two shifts on patrol (up to 8 hours each). 

   6. Must sign all required waivers and agreements. 

   There is a $50 fee to cover some administrative costs. Due to classroom size, the Academy will be limited to 20 persons per academy with no exceptions. Attending the Citizens Police Academy is a privilege, not a right; applicants will be accepted on a first-come, first-serve basis; and will be accepted pending background investigations. 

6. Read carefully and fill out completely.
8. First Name*
10. Middle Name
12. Last Name*
14. Address*
16. City *
18. State*
20. ZIP*
22. Phone *
24. Phone (cell, work, home)
26. Email address*

    This is how you will be notified if accepted to the Citizen's Police Academy. 

28. Date of Birth*
    Date of Birth
30. Race*
32. SS #*
34. Sex*

    1. Male
    2. Female
36. Place of Employment*
38. Title
40. Military Service*

    1. Yes
    2. No
42. Type of Discharge
44. United States Citizen*

    1. Yes
    2. No
46. Have you ever been convicted of an offense other than a traffic offense? *

    1. Yes
    2. No
48. Have you ever been convicted of reckless driving? *

    1. Yes
    2. No
50. Have you ever been convicted of D.U.I?*

    1. Yes
    2. No
52. Do you possess a valid drivers license? *

    1. Yes
    2. No
54. Do you have any physical or mental impairments to prevent you from:
56. Running, Walking, Crawling, or Kneeling? *

    1. Yes
    2. No
58. Use hands to grasp, hold or fire a weapon? *

    1. Yes
    2. No
60. Crouching, Bending, Reaching or Rolling? *

    1. Yes
    2. No
62. Standing, Sitting for moderate periods? *

    1. Yes
    2. No
64. If yes to any, please explain.
66. I agree to be fingerprinted.*

    1. Yes
    2. No
68. I agree to sign a liability release. *

    1. Yes
    2. No
70. I have no known mental disorders and will submit a psychological test. *

    1. Yes
    2. No
72. I am in good physical condition and will submit to a physical examination. *

    1. Yes
    2. No
74. List any physical impairment:

    A physical impairment is NOT an eliminating factor. 

76. REFERENCES
78. Name*
80. Phone*
82. Address*
84. City*
86. State*
88. ZIP*
92. Name*
94. Phone*
96. Address*
98. City*
100. State*
102. ZIP*
106. Name*
108. Phone*
110. Address*
112. City*
114. State*
116. ZIP*
120. Why did you decide to apply for participation in this program? *
122. I certify that the information I have given is true and correct to the best of my knowledge, and authorize investigation of all statements, including my criminal record. I agree to abide by all of the rules and regulations of the Bristol Tennessee Police Department as a participant of the Citizen's Police Academy. I realize any misrepresentation on the application or misconduct will result in my being removed from the program.
124. Signature of Applicant*
126. Date*
     Date
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