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Citizen Police Academy Application

  1. Please check the City of Longview Privacy Policy and Disclaimer before completing this form.
  2. Personal Information
    minimum age for enrollment is 18 years
  3. Identification Number
    Please be prepared to supply a U.S. government I.D. number such as Driver License or State Issued I.D.
  4. month, date, year
  5. area code and phone number
  6. Emergency Contact
  7. area code and phone number
  8. Other Information
  9. Are you a resident of Longview?
  10. How did you hear about CPA?
  11. Criminal History
    Longview Police Department will conduct a criminal history check on each applicant.
  12. Have you ever been arrested?*
  13. Terms of the Program
    I hereby certify that there are no willful misrepresentations, omissions, or falsifications in the foregoing statements and answers to questions. I understand that any omission or false statements on this application shall be sufficient cause for rejection for enrollment or dismissal from the Longview Police Departments Citizen Police Academy. I further understand that the Longview Police Department Academy will be conducting a criminal history check. I declare that I have never been convicted of a felony offense in this state, or any other state, of the United States. I also understand that any student may be removed from the Longview Citizens Police Academy if said student is disruptive or otherwise inhibits the concept of this program.
  14. By typing your name in the above box, you agree to the "Terms of the Program" above.
  15. For additional information check the website at, call 903-237-1108
  16. Leave This Blank:

  17. This field is not part of the form submission.