Southgate, MI

Click the link below to learn more about this years academy

Southgate Citizens Public Safety Academy Application

Full Name (Example: Barry Sanders)*

Address (Example: 123 Road, Southgate, MI 48195)*

Phone Number (Ex. 734-555-1212)*

Driver’s License Number (Ex. S123456789)*

Date of Birth (Ex. 10-01-1958 or October 1st, 1958)*

Are you 18+ years of age?*

Yes

Email Address (Ex. BSanders@DetroitLions.com)

Why do you wish to attend this academy? (Provide one paragraph or longer)

List any clubs or organizations you belong to? (Ex. Rotary, Mason, FOP, Moose, etc.) (If none, type the word None)*

Have you ever been convicted of a crime, felony or misdemeanor? If yes describe.*

Current Employer (Ex. Meijer, Ford Motor, Walmart, etc.)

Current Employer Address (Ex. 123 Hero Rd, Southgate MI 48195)

Current Employer Phone Number (Ex. 734-555-1212)

Current Supervisor Name (Ex. Mickey Mouse)

Hire/Start Date (Ex. May the Fourth, 2020 or 5-4-2020)

Have you ever been fired or asked to resigned from a job in the last 5 years? If yes, please provide details...*

Days

Hours

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday