CPA Application

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Please correct the field(s) marked in red below:

1

Name

 *
2

Home Address

 *
Home Address
3

Contact Information

Contact Information
4

Gender

Gender
5

Birth Information

Birth Information
6
Driver's License Information
Driver's License Information
7
Emergency Contact
Emergency Contact
8
Employer Information
Employer Information
9
Personal Reference 
Personal Reference
10

Community/Civic Organization participation (if any)

11
Why do you wish to participate in the Citizens' Police Academy?
12
If you are not a City of Santa Clara resident, what tie(s) to you have with SCPD or our city?
13
Have you ever had any contact with the SCPD? If so, was your experience positive or negative? Please describe.
14
Have you ever applied to work for the City of Santa Clara? If so, in what capacity?
15
Are there any physical limitations we need to be aware of in order to be able to better assist you to engage in the activities associated with the Citizens Police Academy?
16
Can you commit to attending all the classes?
Can you commit to attending all the classes?
17
Are you at least 21 years of age?
Are you at least 21 years of age?
18
Have you ever been arrested?
Have you ever been arrested?
19
Have you received a non-traffic related citation?
Have you received a non-traffic related citation?
20
Have you ever been convicted of a criminal offense?
Have you ever been convicted of a criminal offense?
21

Are you currently on probation? 

Are you currently on probation?
22
Are you currently on parole?
Are you currently on parole?
23
Certification and Authorization
Certification and Authorization
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