Action Center / Application for Citizen Academy / Florissant, Missouri

Step 1 of 1

Carefully answer each question accurately. An applicant may be disqualified from attending the Citizen Academy if he/she intentionally makes a false statement of material fact or practices or attempts to practice any deception or fraud in this application.

You can either complete this form online, or print off a pdf version and bring it to the Florissant Police Department. The paper form can be found here: Application for Citizen Academy

* Denotes a required field

Full Name Middle initial

List all other names you have used, including maiden names, nicknames and aliases:

Please Do Not Complete The Following Field

Address

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Occupation

Employer

Address

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Employer Phone

Employer Phone Area Code-Employer Phone Prefix-Employer Phone Line Number ext Employer Phone Extension

Home Phone

Home Phone Area Code-Home Phone Prefix-Home Phone Line Number ext Home Phone Extension

Date of Birth

MonthDay Year,

Age

Sex

Male Female

Are you a U.S. Citizen

Do you have a valid Driver License

Yes No

Driver License Number

State Issued

Expiration Date

MonthDay Year,

Contact Email

Have you ever been arrested, detained or taken into custody in this state, any other state, in the military, or any other entity for any reason at all?

Yes No

If yes, please explain: Indicate the date, violation charged, location, court disposition, police agency involved, and report (case) number of incident. A record check will be completed on each applicant.

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