Antioch Police Citizens Academy Application
Complete EVERY question unless stated as “optional” , otherwise, your application may be returned as incomplete
Email Address *
Your answer
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
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State *
Zip Code *
Your answer
Telephone *
Your answer
Mobile Phone (Optional/ If Available)
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Any special considerations? *
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Driver's License # or California ID #
Your answer
Occupation *
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Name of Employer / School *
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Business Phone (Optional)
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How long have you lived in Antioch?
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