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Citizens Univer"City" Application

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First Name*
Last Name*
Home Address*
City*
State*
Zip Code*
Employer
Date of Birth*
Work Address
City
State
Zip Code
Daytime Phone Number*
Evening Phone Number*
Email Address*
Do you live in Seguin, Texas?*
1. Yes
2. No
Number of years living in Seguin, Texas
Have you completed the Citizens Police Academy?*
1. Yes
2. No
Have you completed the Citizens Fire Academy?*
1. Yes
2. No
T-shirt Size*
How did you hear about the Seguin Citizens University?
Briefly state why you are interested in participating in the Citizens University program.

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Citizens Univer"City" Application

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