eMichiganCity.com - The Official Web Site of the City of Michigan City, Indiana: City Departments

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City Departments - Police Department - Citizen's Police Academy

First Name
Middle Name
Last Name
Address
Phone
Work/Other Phone
E-Mail
Shirt Size
Neighborhood in which you live
Date of Birth
Social Security #	We will contact you directly to obtain your Social Security Number, if applicable.
Age
Sex
Race

Educational Background: High School GED College

College Name
Degree Received
Occupation
Employer

Organizations you are a member of (Civic clubs, community organizations, Neighborhood group, etc.)

WHY DO YOU WISH TO ATTEND POLICE ACADEMY?

HAVE YOU EVER BEEN ARRESTED AND/OR CONVICTED OF A CRIME? If yes, explain:

By Clicking Submit -

I give my permission to the Michigan City Police to conduct a background check to determine if I have a criminal record.

I DO HEREBY AUTHORIZE any and all persons, employers, Partnerships, corporations, and all civilian, government, and military agencies, City, County, State and Federal entities to release, furnish and exchange any and all available information relating to me for the purpose of determining my suitability to be appointed as a member of the Michigan City Police Citizen’s Police Academy. This includes but is not limited to all information related to my character, integrity, reputation, conduct and behavior.

I DO HEREBY RELEASE from any and all liability, all persons or entities disclosing information pursuant to this release.

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