ADDRESS*:

CITY*:

ZIP CODE*:

HOME PHONE (area code first):

CELL PHONE (area code first):

E-MAIL ADDRESS:

DRIVER'S LICENSE # (include State)*:

DATE OF BIRTH (MM/DD/YYYY)*:

SEX (M or F):

RACE:

EMPLOYER/SCHOOL NAME:

BUSINESS PHONE (area code first):

HOW WERE YOU REFERRED TO CPA?: A CPA GRADUATE FROM COP CLASS BY A SAPD OFFICER NEWSPAPER/TV ARTICLE SAPD WEB PAGE OTHER

LIST ANY MEDICATIONS AND/OR ALLERGIES WE MAY NEED TO KNOW ABOUT:*

EMERGENCY CONTACT NAME:

PHONE:

HAVE YOU EVER BEEN ARRESTED FOR A FELONY
OR ARE YOU CURRENTLY ON PAROLE OR PROBATION? *
NO YES
(A background check will be conducted on each applicant.
Any intentional misrepresentation will be grounds for immediate dismissal.)

IF "YES", PLEASE EXPLAIN:

AGREEMENT:
BY SUBMITTING THIS FORM, I HEARBY ACKNOWLEDGE THAT I HAVE COMPLETED THE ABOVE INFORMATION FULLY AND ACCURATELY. I UNDERSTAND AND GIVE MY PERMISSION, WITH RESPECT TO THE SAN ANTONIO POLICE DEPARTMENT, TO CONDUCT A BACKGROUND INVESTIGATION TO DETERMINE MY SUITABILITY FOR ADMISSION TO THIS PROGRAM? *

I AGREE TO THE CONDITIONS I DO NOT AGREE TO THE CONDITIONS