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2. Name*
4. Gender (Male or Female)*
5. Date of Birth*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Home Phone*
14. Cell Phone*
16. Email Address*
18. Employee or Company*
20. Have you ever been arrested for a non-traffic offense? (Yes or No)*
21. If yes, briefly explain*
23. Briefly state why you wish to attend the CPA*
24. Hair Color, Eye Color & Height*
    For I.D. Card information, please provide the following information
26. How did you learn about the HDPS Citizen's Police Academy?*
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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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