| Mike Mullins | City of Natchez |
Tele (601) 445-5565 |
Chief of Police |
POLICE DEPARTMENT | Fax (601) 442-3487 |
Post Office Box 1423 |
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Natchez, Mississippi 39121 |
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CITIZEN'S POLICE ACADEMY |
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| APPLICATION FOR ENROLL |
(PLEASE PRINT and mail to Natchez Police Department Attn: Officer Charles Woods, 233 Devereaux Dr, Natchez, MS 39120)
NAME: ________________________________________________ D.O.B. _________
ADDRESS: _____________________________________________________________
CITY/STATE/ZIP: _______________________________________________________
HOME PHONE: ______________________ WORK PHONE: __________________
OCCUPATION: ________________________ EMPLOYER: ____________________
DRIVER'S LICENSE: ______________ SOCIAL SECURITY: ________________
COMMUNITY/GROUP/ORGANIZATION AFFILIATION (if applicable):
_______________________________________________________________________
WHY DO YOU WISH TO ATTEND THE CITIZEN'S ACADEMY? _______________
________________________________________________________________________
________________________________________________________________________
HOW DID YOU HEAR ABOUT THE CITIZEN'S ACADEMY? __________________
________________________________________________________________________
GIVE THE NAME/ADDRESS/PHONE NUMBER OF TWO REFERENCES:
1.) _____________________________________________________________________
2.) _____________________________________________________________________
(Mail to: Natchez Police Department, 233 Devereaux Drive, ATTN: Charles Woods, Natchez, MS 39120)