NEWTOWN POLICE DEPARTMENT
Citizen Police Academy XIV
STUDENT PARTICIPATION APPLICATION
Name: Date of Birth:
Home Address:
Mailing Address:
Employer:
Home Phone: Other Phone:
Email:
Reason for Applying:
Subject matter that you would like to see covered in the CPA:
Please return to:
Newtown Police Department
3 Main Street
Newtown, CT. 06470
Attn: SRO Domenic Costello
Ph: (203)426-5841 fax: (203)270-0637
NOTE: Applicants will be subject to a Criminal History Record Verification prior to acceptance into the Citizen Police Academy. Please mail or fax the completed application as soon as possible. Space is limited to 25 students.
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