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2. If you have questions regarding this application, or you would like to fill out a hard copy, please contact Kerrigan Blandin, Public Information & Engagement Manager, at kblandin@brightonco.gov.
4. If you have questions regarding the BPD Teen Academy, please see your school's SRO or contact Officer Ramirez at dramirez@brightonco.gov or Officer Delein at cdelein@brightonco.gov.
6. WAIVER REQUIRED
   BPD Teen Academy Waiver

   Prior to submitting your application, please fill out the BPD Teen Academy Waiver and submit it in the space provided below. If you are unable to fill out the waiver and attach it to this application, please notify Officer Ramirez or Officer Delein. You will be required to fill out a hard copy prior to the start of the first session.

8. UPLOAD WAIVER
10. First Name*
11. Last Name*
13. Address1*
15. Address2
17. City*
18. State*
19. Zip*
21. Email *
23. Date of Birth*

    (MM/DD/YYYY)

24. Phone Number*
25. Driver's License # or Driver's Permit # (If Applicable)
27. Shirt Size*

    1. XS
    2. S
    3. M
    4. L
    5. XL
    6. XXL
28. What is your current GPA?*
29. What school do you attend?*
31. Parent/Guardian Name*
32. Parent/Guardian Phone Number*
34. Parent/Guardian Email*
36. Have you EVER been arrested or convicted of any petty crime, misdemeanor or felony?*

    If no, please write No or N/A. If yes, please provide details. Please include the date and location.

38. Briefly describe your reasons for wanting to attend the BPD Teen Academy.*
40. Will transportation be an issue?*

    1. Yes
    2. No

    Transportation is not provided by the Brighton Police Department. Participants are responsible for coordinating their own transportation to and from each session.

42. How did you hear about the BPD Teen Academy?*
44. List the person to be contacted in case of emergency during your attendance at the BPD Teen Academy:
46. First Name*
47. Last Name*
49. Relationship*
50. Phone Number*
52. I hereby certify that the information contained in this application is true and complete to the best of my knowledge. *

    1. Yes
54. By signing below, I am agreeing that you are hereby authorized to make any investigation of my personal history deemed necessary for consideration to attend the BPD Teen Academy.
56. Please sign by typing your name below.*
57. Date*
Leave This Blank:


59. Submit

* indicates a required field