Alexandria Police Department
Teen Law Enforcement Academy
Teen Law Enforcement Academy Application
Coordinator:
Dylan.ignacio@alexandriava.gov
Academy Requirements:
Applicants must be 14 to 18 years of age.
Applicants preferred to live or go to school in the city of Alexandria.
Applicants must have clean criminal history (questions regarding this, please contact coordinator)
Class size limited to 30 participants.
NOTE: * - Required Fields
Applications are to be submitted no later than Friday, December 20, 2019. For questions about Teen Law Enforcement Academy application, email
Dylan.Ignacio@alexandriava.gov
.
Participant Information:
*
Name:
(Required.)
*
Shirt Size:
(Required.)
XS
S
M
L
XL
XXL
Date of Birth:
*
Month
(Required.)
January
February
March
April
May
June
July
August
September
October
November
December
*
Date:
(Required.)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
*
Year:
(Required.)
2000
2001
2002
2003
2004
2005
*
Address:
(Required.)
*
City:
(Required.)
*
State:
(Required.)
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code:
(Required.)
*
Home Phone Number:
(Required.)
Cell #:
School Attending:
Grade:
Parent / Guardian Name:
Address
(if different)
:
*
City:
(Required.)
*
State:
(Required.)
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code:
(Required.)
*
Home Phone Number:
(Required.)
*
Work #:
(Required.)
Emergency Contact:
*
Telephone Number:
(Required.)
*
Provide a 3-5 paragraph explanation of why you want to attend the Teen Law Enforcement Academy.
(Applications submitted without this completed will be disregarded.)
(Required.)
AS A STUDENT OF THE ACADEMY YOU WILL BE ALLOWED ACCESS TO SENSITIVE AREAS WITHIN THE POLICE DEPARTMENT. A REVIEW OF ANY CRIMINAL RECORDS WILL BE CONDUCTED.
I understand that this training will not authorize me to carry a firearm or exercise any law enforcement powers granted by the THE CITY OF ALEXANDRIA, VIRGINIA. I also agree to allow photos/ videos to be taken of me and be posted on social media as well as be used for the promotion of the academy.
I certify that the foregoing information is true and complete to the best of my knowledge and belief. I consent to the City's use of any photo or video recording of my participation in the Teen Law Enforcement Academy sessions. NOTE: Please enter your full legal name below. Typing your full legal name will serve as a signature for this request.
Applicant's Name:
Parent / Guardian Name
(if not 18)
: