Guardian Academy Application

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Guardian Academy Application
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Buckeye Police Department Guardian Academy Application 


APPLICANT INFORMATION

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Full Name
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Address
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City, State, Zip Code
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Phone
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Email

PERSONAL INFORMATION

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How many children/foster children do you have?
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What are the ages?
What are the ages?
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How did you hear about the Guardian Academy?
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The academy sessions are on weekday evenings for 4 weeks.  Are you able to attend all sessions?
The academy sessions are on weekday evenings for 4 weeks. Are you able to attend all sessions?
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What experiences have you had with law enforcement?  Positive/negative?  Briefly explain

EMPLOYMENT EXPERIENCE

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Company
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Address
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Phone 
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Supervisor
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Responsibilities
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Dates of employment (from/to)
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Reason for Leaving

BACKGROUND INFORMATION

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Driver's License Number
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State
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Have you ever been arrested for a crime, regardless of whether the conviction was later set aside or expunged?  A "crime" means all felonies, misdemeanors and serious offenses.  Examples include, but are not limited to DWI/DUI, criminal traffic offenses, domestic violence, assault and drug offenses.
Have you ever been arrested for a crime, regardless of whether the conviction was later set aside or expunged? A "crime" means all felonies, misdemeanors and serious offenses. Examples include, but are not limited to DWI/DUI, criminal traffic offenses, domestic violence, assault and drug offenses.
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If yes, please explain

EDUCATION

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Do you have a High School Diploma?
Do you have a High School Diploma?
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Name of College or University
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Major/Degree Earned
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Graduates Studies
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Major/Degree Earned

EMERGENCY CONTACT INFORMATION

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Name
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Address
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Relationship
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Emergency Phone Numbers
 *
Emergency Phone Numbers

DISCLAIMER AND SIGNATURE

The City of Buckeye Police Department appreciates those people who are interested in attending the Buckeye Guardian Academy.  In order to protect confidential Police Department information, laws have been enacted to protect the people we serve.  This law requires that anyone with access to sensitive areas in a police facility is subject to a background check.  The background check in minimal but absolutely necessary. 

I fully understand, acknowledge and agree to the following:

A minimal background check is required before enrollment is allowed in the Guardian Academy.

All statements made in this application are true and authorization is given to investigate all matters contained in the application.  Any false statements or misrepresentation on this application will be cause for refusal of enrollment or dismissal at any time during the academy.

 

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*In lieu of a written signature, please type your full name below.
 *
*In lieu of a written signature, please type your full name below.
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*Confirmation of signature
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    Thank you for your interest in attending the Guardian Academy!