Social Circle Police Department
Teen Leadership Academy
Registration Form
Name:
Address:
Date of Birth:
Home Phone:
Emergency Contact:
Emergency Phone:
T-Shirt Size:
Parent Signature is required for those under the age of 18.
Parent Signature:
Please return this form to School Resource Officer Jett
Or to the Police Department in person to:
Social Circle Police Department
138 E. Hightower Trail
Social Circle GA 30025
Or by mail to:
Social Circle Police Department
PO Box 310
Social Circle GA 30025
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