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AUBURN HILLS POLICE DEPARTMENT
YOUTH POLICE ACADEMY 2019 | APPLICATION 1899 N. SQUIRREL RD., AUBURN HILLS, MI 48326 | (248) 370-9460
APPLICANT’S NAME: ___________________________________ LAST FIRST MIDDLE
APPLICATIONS DUE: MAY 10TH, 2019YOUTH POLICE ACADEMY INFORMATION
WHO CAN PARTICIPATE? ANY CURRENT HIGH SCHOOL JUNIOR OR SENIOR (CAN BE ENTERING YOUR JUNIOR
OR SENIOR YEAR, ALSO APPLIES TO SENIORS WHO JUST GRADUATED) WHO LIVES IN OR ATTENDS HIGH SCHOOL IN OAKLAND COUNTY OR HAS A PARENT WHO LIVES, WORKS OR GOES TO SCHOOL IN AUBURN HILLS.
MUST HAVE A MINIMUM GPA OF 2.0 AND BE IN GOOD ACADEMIC STANDING. MUST POSSESS GOOD MORAL CHARACTER, A GOOD WORK ETHIC AND
DEMONSTRATE THEIR HONESTY AND TRUSTWORTHINESS. BE IN GOOD LEGAL STANDING WITH AN ACCEPTABLE LEGAL HISTORY BE IN GOOD PHYSICAL CONDITION AND PROVIDE PROOF OF A PHYSICAL BY A
LICENSED PHYSICIAN WITHIN 12 MONTHS OF THE ACADEMY AUTHORIZE THE AUBURN HILLS POLICE DEPARTMENT AND ITS AGENTS TO UTILIZE
THE LEIN/NCIC SYSTEM TO CONDUCT A THOROUGH BACKGROUND CHECK
ACADEMY DATE & MANDATORY INFORMATIONAL MEETING: JUNE 24TH – JUNE 28TH, 2019 | 8:00AM-4:00PM (ALL ACADEMY DAYS ARE
MANDATORY) GRADUATION TO TAKE PLACE AT THE AUBURN HILLS CITY COMPLEX ON
FRIDAY JUNE 28TH. MANDATORY INFORMATIONAL MEETING: WEDNESDAY, JUNE 19TH, 2019 @
7:00PMO MEETING WILL TAKE PLACE IN THE AUBURN HILLS PUBLIC SAFETY
COMMUNITY ROOM ATLEAST ONE PARENT MUST BE IN ATTENDANCE BRING A COPY OF HEALTH INSURANCE INFORMATION/BE ABLE
TO PROVIDE MEDICAL HISTORY OF THE STUDENT
SUBMIT COPIES OF THE FOLLOWING WITH YOUR APPLICATION: DRIVER’S LICENSE/STATE IDENTIFICATION CARD (IF APPLICABLE) STUDENT IDENTIFICATION CARD PROOF OF PHYSICAL WITHIN 12 MONTHS OF THE ACADEMY DATE COPY OF YOUR RESUME REPORT CARD OR RECENT TRANSCRIPT SHOWING GOOD ACADEMIC
STANDING ALL SIGNED WAIVER FORMS
AUBURN HILLS POLICE DEPARTMENTYOUTH POLICE ACADEMY 2019 | APPLICATION
WHAT WILL BE PROVIDED: UNIFORM PIECES ALL MATERIALS INCLUDING BOOKS AND CLASSROOM SUPPLIES LUNCH DURING EACH DAY OF THE ACADEMY
WHAT YOU WILL NEED TO PROVIDE: BLACK BOOTS OR SHOES AND BLACK SOCKS KHAKI PANTS WORKOUT/ATHLETIC ATTIRE
O DARK BLACK OR BLUE T-SHIRTO DARK BLACK OR BLUE ATHLETIC SHORTSO GOOD RUNNING/ATHLETIC SHOES WITH SUPPORT
DUFFLE BAG OR BACKPACK TO CARRY MATERIALS TRANSPORTATION TO AND FROM THE AUBURN HILLS POLICE DEPARTMENT
BEFORE AND AFTER THE ACADEMY SUNSCREEN, BUG SPRAY (IF YOU FEEL NECESSARY) AND ANY MEDICATIONS
YOU WILL NEED TO TAKE DURING THE ACADEMY
CONTACT INFORMATION
ALL QUESTIONS OR CONCERNS SHOULD BE DIRECTED TO:
OFFICER JOE SEARS1899 N. SQUIRREL RD.,AUBURN HILLS, MI 48326-2753(248) 364-6789 EXT. [email protected]
APPLICATION INSTRUCTIONS READ EVERY QUESTION CAREFULLY AND ANSWER ALL QUESTIONS ON THE
APPLICATION IF THE QUESTION DOESN’T APPLY TO YOU, FILL IN N.A. DO NOT LEAVE ANY
PART OF THE APPLICATION BLANK
AUBURN HILLS POLICE DEPARTMENTYOUTH POLICE ACADEMY 2019 | APPLICATION AUBURN HILLS POLICE DEPARTMENTYOUTH POLICE ACADEMY 2019 | APPLICATION
YOUR APPLICATION SHALL BE PRINTED CLEARLY IN YOUR OWN HANDWRITING OR FILL IN THE APPLICATION VIA THE COMPUTER AND TYPE
ANSWERS INTO THE BLANKS ANSWER EVERY QUESTION COMPLETELY AND TRUTHFULLY, IF THERE IS INSUFFICIENT SPACE TO ANSWER, INCLUDE AN ADDITIONAL SHEET OF PAPER
WITH THE QUESTION NUMBER AND ANSWER
SEND ALL COMPLETED MATERIALS BY FRIDAY, MAY 10 TH , 2019
VIA EMAIL: [email protected]
OR
MAIL OR DELIVER IN PERSON:
ATTN: OFC SEARSAUBURN HILLS POLICE DEPARTMENT
1899 N. SQUIRREL RD., AUBURN HILLS, MI 48326
AUBURN HILLS POLICE DEPARTMENTYOUTH POLICE ACADEMY 2019 | APPLICATION
APPLICANT INFORMATIONLast Name First M.I. DateStreet Address
Apartment/Unit #
City State ZIP
Phone E-mail Address
Parent/Guardian
Parent/Guardian
Parent/Guardian
Do you live, work or attend a school in the City of Auburn Hills? If so, provide the name and address of the Have you attended OUR academy before? YES NO Are you available from June 24th-June
28th, 2019? YES NO
Have you ever been arrested? YES NO If so, when?Have you ever been convicted of a misdemeanor or felony? YES NO If yes,
explain
EDUCATION (IF THERE IS NOT ENOUGH SPACE FOR AWARDS, INCLUDE ADDITIONAL SHEET/LIST)Jr. High (6-8) Address
From To
Did you graduate? YES NO Award
sHigh School Address
From To
Did you graduate? YES NO Award
sCollege/
Tech School Address
From To
Did you graduate? YES NO Award
sWere you ever expelled or suspended from High School or Jr. High? If so explain: when, where and reason on the back of this page.REFERENCESPlease list One Personal Reference (Family Member, Friend) and Two Professional References (Boss, Coach, Teacher).
Full Name Relationship
Company Phone
Address
Full Name Relationship
Company Phone
Address
Full Name Relationship
Company Phone
Address
EMPLOYMENT HISTORY (CHRONOLOGICAL ORDER WITH CURRENT/MOST RECENT JOB FIRST)Company Phone
Address Supervisor
Job TitleIf current job,
list hours that you
workResponsibilities
From To Reason for LeavingMay we contact your previous supervisor for a reference? YES NO
Company Phone
Address Supervisor
Job TitleIf current job,
list hours that you
workResponsibilities
From To Reason for LeavingMay we contact your previous supervisor for a reference? YES NO
Company Phone
Address Supervisor
Job TitleIf current job,
list hours that you
workResponsibilities
From To Reason for LeavingMay we contact your previous supervisor for a reference? YES NO
VOLUNTEER/EXTRA-CURRICULAR ACTIVITY List extra-
curricular activityTotal
Hours per Week
Does this conflict with the academy?
List Volunteer activity/organizati
ons
DISCLAIMER AND SIGNATUREI certify that my answers are true and complete to the best of my knowledge. I understand that false or misleading information in my application or interview will result in my release. Furthermore I acknowledge that the Auburn Hills Police Department reserves the right to suspend or terminate the participation of any participant who engages in unsafe, insubordinate, or illegal behavior at any time before or during the Youth Police Academy. Finally, my submission of this application permits the Auburn Hills Police Department and its agents to perform a background check utilizing the LEIN/NCIC, Secretary of State and CLEMIS systems.
Signature Date
