Forms • Riverdale • CivicEngage

Citizen Public Safety Academy

Leave This Blank:

Full Name*

Address*

City/Zip*

Email Address*

Date of Birth*

Race*

Male/Female*

Driver's License Number*

State of Issue*

Place of Employment*

Occupation*

Work Number*

Community Group Affiliation (if any)

Why do you wish to attend the Citizen Public Safety Academy?*

How did you hear about the Citizen's Public Safety Academy?*

Have you ever been convicted of a felony?

YES

I hereby authorize the Riverdale Police Department to make an examination of my criminal history records and driving records, for the purpose of evaluating my eligibility for the Citizen Public Safety Academy. I fully understand that incorrect, misleading, or incomplete information may be cause for rejection of my application

This check mark signifies authorization of background check related to my application

* indicates required fields.

Live Edit

Contact Us

Quick Links

Site Links