Police Academy Candidate Interest Form

If you think the HCC Police Academy might be part of your education and career path, we’d like to keep in touch. Please fill out the form below so we can keep you informed of information sessions and special events.

Name

Street Address

City

State

- Select -Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Marianas Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Email Address

Phone Number

Current School

- Select -Hagerstown Community College Boonsboro Middle Clear Spring Middle E. Russell Hicks Middle Northern Middle Smithsburg Middle Springfield Middle Western Heights Middle Barbara Ingram School for the Arts Boonsboro High Clear Spring High Hancock Middle/High North Hagerstown High Smithsburg High South Hagerstown High Washington County Technical High Williamsport High N/A Other

Current School (other)

Current Grade

- Select -6th 7th 8th 9th 10th 11th 12th N/A Other

Current Grade/Year (other)

Date of Birth

Do you plan to attend HCC when you graduate?

- Select -Yes No Unsure I currently attend HCC

Do you plan to attend the HCC Police Academy?

- Select -Yes No Unsure