2. 
4. Eligibility

   You must be at least 21 years of age and live or work in the City of Bedford. A background check will be performed on all applicants. 

6. Name (Last, First, Middle)*
8. Address*
10. City*
11. State
12. Zip Code
14. Daytime Phone Number*
15. Alternate Phone Number
17. Email Address*
19. Date of Birth*
20. Sex
    -- Select One --MaleFemale
22. Driver's License State*
23. Driver's License Number*
25. Place of Employment*
27. Business Address*
29. Work Phone
31. Occupation Title
33. Shirt Size*
35. Have you ever been arrested or convicted of any offense other than a Traffic Violation? If yes, please provide details.*
37. I hereby authorize the Bedford Police Department to conduct a review of my background for purposes of admittance to the Citizen’s Police Academy.**

    1. Yes
    2. No
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit Submit and Print

* indicates a required field