Junior Police Academy
APPLICATION FORM
[The information you provide to us will be used by the Moorhead Police Department only]

If your child is interested in attending the Moorhead Police Department Junior Police Academy and you would like more information, please provide the following information about the child interested in attending:

FIRST NAME  
MIDDLE INITIAL  
LAST NAME  
STREET ADDRESS  
APPARTMENT NUMBER
CITY  
STATE
ZIP CODE
TELEPHONE NUMBER
NAME OF SCHOOL YOU WILL ATTEND IN 07-08:  
GRADE LEVEL YOU WILL BE IN THE 07-08 SCHOOL YEAR  
PARENT/GUARDIAN NAME  
PARENT TELEPHONE NUMBER
PARENT EMAIL ADDRESS  
 
WHICH SESSION CAN YOU ATTEND?
 
 
 
 
 
BRIEFLY DESCRIBE WHY YOU WOULD LIKE TO PARTICIPATE IN THE JUNIOR POLICE ACADEMY?