Please complete the following form to apply for the next Community Police Academy which starts on April 1, 2026. This is a 10 week program, and meets every Wednesday night from 6pm to 9pm. There is no cost to attend, and you must be 18 years of age to apply.

- You must be at least 18 years of age

- You should live or work in the City of San Rafael

- You must not be convicted of a felony, or prohibited from owning or possessing a firearm

- Applications must be received by March 20, 2026

** This application is for the next class, which begins April 1, 2026 **

Applicant Information:

First Name:
Middle Name:
Last Name:
Alias:
Date of Birth:	(You must be at least 18 years of age)
Address:
City:
State:
Zip Code:
Home Phone:
Office Phone:
Other Phone:
Email Address:

Drivers License Number:
Drivers License State:
Drivers License Class:
Drivers License Expiration Date:
Is your Drivers License Currently Valid?	YES NO

Have you ever been convicted of any felony?YES NO
If yes, please explain where, when, and disposition:

Place of Employment:
Employer Address:
Duties Performed:

How do you feel the community police academy will benefit you?

What is your opinion of the San Rafael Police Department?

I hereby certify that the answers are true and correct. By pressing "Submit", I authorize any of the academy law enforcement agencies to do a criminal history and background check for the purposes of this academy.

Protecting the Mission City