« previous page	Albuquerque Police Department Citizen Police Academy Application
	All fields must be completed.
Last Name	First Name  MI
Street	Apt
City	State  Zip
Home Phone	Work  Other
Birth Date
Social Security No.
Drivers License No.	State  Expiration
Current Employment
	Have you ever been convicted of a felony? Yes      No
	Have you been arrested for any misdemeanor, including DWI, within the last 3 years? Yes      No
	If you are active with any neighborhood, community, or civic organizations, please list below:
	I fully understand that any intentional attempt on my part to provide INCORRECT or MISLEADING information would be just cause for rejection of my application.
Applicant Signature	____________________________________________   Date______________
	NOTE: Print button works only with Windows; Mac users must print from toolbar. Print the completed application then mail or fax signed application to: A.P.D. Citizen Police Academy 5412 2nd Street N.W., Albuquerque, N.M. 87107 Office: (505) 343-5000 FAX: (505) 343-5025