Newtown Police Department
Citizen Police Academy XVII
STUDENT PARTICIPATION APPLICATION
Name: Date of Birth:
Home Address:
Mailing Address:
Employer:
Home Phone: Other Phone:
Email:
Reason for applying:
- Please return to: Newtown Police Department
3 Main Street
Newtown, CT. 06470
Attn: Sgt. David Kullgren
Ph: (203)426-5841 fax: (203)270-0637
NOTE: Applicants will be subject to a Criminal History Record Verification prior to acceptance into the Citizen Police Academy.
Please mail, email, drop off or fax the completed application before 03/01/12.
Space is limited to 25 students, Newtown Residents have first priority.
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