HomeMy WebLinkAboutCPA Application 2023_202210271516492534Johnson County Community Police Academy 2023 Application
Hosted by the Coralville Police Department, Iowa City Police Department,
Johnson County Sheriff’s Office, North Liberty Police Department and the
University of Iowa Police Department
Please type or print legibly in blue or black ink.
Name: Address:
First Middle Last Street Phone:
City State Zip Code Cell/Home Work
Date of Birth:
Email:
Driver’s License Number & State:
Employer: Occupation:
Employer’s Address:
Street
City State Zip Code
Have you been arrested for any offense other than a traffic violation? Yes No If yes, what for? When? Where?
Are you able to attend six or more sessions? Yes No
Why do you want to attend the Citizen’s Police Academy? What shirt size do you wear? S M L XL XXL XXXL A $10 participation fee is required to cover the costs of material & shirts. Please bring payment the first week of class. Make checks payable to the Community Police Academy.
I hereby certify that the information in this application is true and complete to the best of my knowledge. You are
authorized to make any investigation of my personal history deemed necessary of consideration to attend the Community Police Academy.
Applicant signature Date
Johnson County Community Police Academy 2023 Participant Instructions
Hosted by the Coralville Police Department, Iowa City Police Department,
Johnson County Sheriff’s Office, North Liberty Police Department and the
University of Iowa Police Department
1. The Community Police Academy shall not interfere with routine operations of any law enforcement agency.
2. During ride along activities, participants will follow all instructions given by the officer. No interference with the performance of any officer shall be permitted. 3. The student shall not be armed at any time.
4. Participants who are asked to identify themselves should explain that they are a Community Police Academy participant.
5. SMOKING IS NOT ALLOWED in any government building or vehicle. 6. A criminal records check will be conducted on all applicants prior to acceptance into the Academy. 7. All participants will conduct themselves in an appropriate and professional manner.
8. Violation of any instruction, guideline, rule or failure to comply with a reasonable request will terminate the citizen’s participation in the Academy. This is at the discretion of any member of
the Coralville, Iowa City, North Liberty, or University Police Departments, or Johnson County Sheriff’s Office. 9. The maximum number of times a participant can attend the Community Police Academy is two. 10. The maximum number of times a participant can miss class is 3 times, total during the academy. 11. All applicants must be at least 16 years of age by January 23rd, 2023.
In consideration of the above law enforcement agencies granting permission to enter in or upon any premises or vehicles which are under their actual care or constructive or passive control, I hereby waive all claims to damage or
loss to my person or property which may be caused by any act, or failure to act, of the Coralville, Iowa City, North Liberty and/or University Police Departments, and/or Johnson County Sheriff’s Office officers, agents or employees.
I assume the risk of all dangerous conditions in, upon or about the premises or vehicles and waive any and all notice or existence of such conditions. I certify that I understand the requirements and responsibilities of participants in this program.
Applicant signature Date
Please mail or hand-deliver completed applications to the Coralville Police Department, Iowa City Police Department, Johnson County Sheriff’s Office, North Liberty Police Department or the University of Iowa Police Department. Applications must be received by 5pm on January 9, 2023 to be considered for the 2023 Academy.