Citizens’ Academy Application

Last:*
First:*
Middle:*

Middle Name:
List all other names you have used, including nicknames and maiden names. If you have ever used any legally changed name, please list the time period this occurred and the circumstances.
Residence Address:*
City:*
State:*
Zip Code:*
Phone:*

Best phone number to contact you:
Date of Birth:*

mm/dd/yyyy
Driver's License State Issued:
Sex
Choose One
Email*
Enter Email Confirm Email

Email address where you can be reached: jdoe@email.com

Ethnicity
Submission of this section is voluntary:

Employer:
Employer Address:
City:
State:
Zip Code:
Company Website:

ex. www.website.com
Job Title:

List any organizations, association, or community groups to which you belong:
List prior citizen's academies and dates of graduation:
Please let us know why you are interested in attending the Sheriff's Citizen's Academy:*
Please tell us where you heard about the Sheriff's Citizen's Academy:*
ex. word of mouth, friend/family member, website, radio advertising.
Our citizens' academy will involve meeting at several different locations around Nashville having classroom settings and tours that will require walking. Please let us know of any accommodations that would need to be made for you to participate, including dietary restrictions. This will not preclude you from being eligible to participate. Any request for accommodations must be made in advance.*
Do you have any relatives and/or close associates who are incarcerated with the Davidson County Sheriff's Office or with the former Metro Detention Center? (This will not preclude you from being considered for participation)*
- Yes
- No
If "Yes", list the person's name(s) and your association with each person:
Incarcerated person's name:

Last, First, MI
Relationship:

ex. Brother, Wife, Neighbor, Childhood Friend
Housing Location (if known):

ex. CDM, DDC, MCC
At the time of this application, are you UNDER 21 years of age?*
- Yes
- No
(must answer to continue)
Have you ever been arrested or convicted of any criminal offense?*
- Yes
- No
If you answered "yes" to the above question about convictions, please explain:

Consent*
As an applicant for the Davidson County Sheriff's Office Citizens' Academy, I hereby authorize the Davidson County Sheriff's Office (DCSO) to conduct a criminal history background investigation, including convictions, pending charges, and outstanding warrants. I understand that this criminal history check is being conducted due to the nature of the classes given at the Citizens' Academy.
As an applicant for the Davidson County Sheriff's Office Citizens' Academy, I hereby authorize the Davidson County Sheriff's Office (DCSO) to conduct a criminal history background investigation, including convictions, pending charges, and outstanding warrants. I understand that this criminal history check is being conducted due to the nature of the classes given at the Citizens' Academy.
Consent*
I understand that all available police and criminal records will be checked and that the information will be used in determining eligibility of applicants for the Citizens' Academy. All information is to remain confidential as required by state and federal statutes.
I understand that all available police and criminal records will be checked and that the information will be used in determining eligibility of applicants for the Citizens' Academy. All information is to remain confidential as required by state and federal statutes.
Consent*
I understand the DCSO Citizens' Academy is NOT a DCSO training program for certification as a correctional officer.
I understand the DCSO Citizens' Academy is NOT a DCSO training program for certification as a correctional officer.
Consent*
I certify that all statements made on this application are true and complete. I authorize the Davidson County Sheriff's Office to examine this information to evaluate my participation in the Sheriff's Citizen's Academy.
I certify that all statements made on this application are true and complete. I authorize the Davidson County Sheriff's Office to examine this information to evaluate my participation in the Sheriff's Citizen's Academy.
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Citizens' Academy Application

Step 1 of 5

If "Yes", list the person's name(s) and your association with each person: