teen academy application .pdf

File information


Original filename: teen academy application.pdf
Author: tmcleod

This PDF 1.5 document has been generated by Microsoft® Word 2013, and has been sent on pdf-archive.com on 01/05/2019 at 21:44, from IP address 72.240.x.x. The current document download page has been viewed 260 times.
File size: 271 KB (1 page).
Privacy: public file


Download original PDF file


teen academy application.pdf (PDF, 271 KB)


Share on social networks



Link to this file download page



Document preview


APPLICATIONS ACCEPTED BEGINNING MAY 1, 2019
City of Oregon Police Department

TEEN ACADEMY APPLICATION
TEEN INFORMATION
Name: _________________________________________
Home Address: _________________________________
City, State, Zip: __________________________________
OH Driver’s Lic. #: ________________________________

Home Phone: (______)_______________________________
Cell Phone: (_______)________________________________
Email: _____________________________________________
Exp. Date: _________________________________________

PARENT INFORMATION
Parent 1 Name: __________________________________ Parent 2 Name: ____________________________________
Parent 1 Cell: (______)_____________________________ Parent 2 Cell: (_____)________________________________
Parent 1 Email: ___________________________________ Parent 2 Email: ____________________________________

QUESTIONNAIRE (FOR TEEN)
What school do you attend? _________________________________________________ Grade: __________________
How old are you? _______________
Have you ever been arrested or convicted of any criminal offense?
_______yes
_______no
Do you have any medical conditions that limit your activities?
_______yes
_______no
If you answered “yes” to either of the questions above, please explain:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Please let us know why you are interested in attending the Teen Academy:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

ELIGIBILITY FOR ATTENDANCE IS AT THE SOLE DISCRETION OF THE POLICE DEPARTMENT
By signing below, I attest that the above information is true and correct and
I consent to a juvenile, D.M.V., and/or criminal records check.

Student Signature: _____________________________________________________________ Date: ________________
Parent or Guardian Signature: ____________________________________________________ Date: _______________


Document preview teen academy application.pdf - page 1/1


Related documents


teen academy application
kc 2015 2016 registration form
hpa application digital
application
steam policies 2018
2 application part 2

Link to this page


Permanent link

Use the permanent link to the download page to share your document on Facebook, Twitter, LinkedIn, or directly with a contact by e-Mail, Messenger, Whatsapp, Line..

Short link

Use the short link to share your document on Twitter or by text message (SMS)

HTML Code

Copy the following HTML code to share your document on a Website or Blog

QR Code

QR Code link to PDF file teen academy application.pdf