Citizen Public Safety Academy Application
Return com
pleted applications to Leslie Griffin at the Police Department
(griffinl@concordnc.gov
; P.O. Box 308, Concord NC, 28026; or fax: 704-920-6970)
Participating Departments - Please contact us if you have questions:
Concord Police Department – 704-920-5000
Concord Communications Department – 704-920-5587
Concord Fire Department – 704-920-5516
Concord Emergency Management – 704-920-5211
Application Date: ____________
Please print or type:
Name: _____________________________________________ Telephone: ______________
Address: _____________________________________________________________________
Occupation: __________________________________________________________________
(past or current profession/employment/business)
Email: ___________________________________________________________
Special Public Safety Interests/Activities:
How did you learn about the Citizen Public Safety Academy (please check all that apply)?
City Circular City Website Word of Mouth Other _____________________
Are you a current resident or business owner/operator in Concord? Yes ____ No _____
If yes to the above, how long have you resided or owned/operated a business in Concord?
If no to
the answer above, what is the reason(s) for your interest in Concord Public Safety Academy?
Have you participated in Concord 101? Yes_____ No______
If not, would you like to learn about this opportunity? Yes_____ No______
Have you had prior participation in any citizens’ academy programs? Yes ____ No ____
If so, when and where did you participate? ___________________________________________________
Return completed applications to Leslie Griffin at the Police Department
(griffinl@concordnc.gov
; P.O. Box 308, Concord NC, 28026; or fax: 704-920-6970)
Thank you for your interest in the City of Concord!
