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The Holland Department of Public Safety
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89 West 8th Street
Holland, MI 49423
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Home
» Citizen's Police Academy Application
Citizen's Police Academy Application
Categories
User Categories:
Residents
Name::
*
Gender (Male or Female)::
*
Date of Birth::
*
Address (street, City, State, ZIP Code)::
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Home Phone::
*
Cell Phone::
*
Drivers License # (or State I.D.)::
*
Social Security Number::
*
E-mail address::
Employer or Company::
*
Have you ever been arrested for a non-traffic offense? ( YES or NO ):
*
If "Yes" to the above question, briefly explain::
*
Briefly state why you wish to attend the CPA?:
*
Hair Color, Eye color, Height::
*
For I.D. Card information, please provide the following info:
How did you learn about the HDPS Citizen's Police Academy?:
*
