ATF CITIZENS ACADEMY APPLICATION
List all other names (nicknames, maiden name)
Date of Birth
Place of Birth
Current Address (Street Name and Number)
District Of Columbia
Business Address (Street Number & Name, City, ZIP)
List organizations, associations or community groups to which you belong:
How did you learn about ATF Citizens Academy?
Why are you interested in attending the ATF Citizens Academy?
In what way will your attendance at the ATF Citizens Academy benefit your community?
If selected to attend the ATF Citizens Academy, would you be willing to support the ATF Citizens Academy Alumni Association at community events, critical incidents and similar functions?
What other Citizens Academies have you attended?
AUTHORIZATION TO CONDUCT LAW ENFORCEMENT CHECK
Have you been arrested within the last 6 months?
Have you ever been convicted of a felony or serious misdemeanor?
If you answered YES to either question, please provide details including date, place, law enforcement agency, charges, court and disposition:
I hereby authorize ATF to conduct a standard check of law enforcement records pursuant to my application to the ATF Citizens Academy. I understand this check will include, but not be limited to, any record of arrests, prosecutions or convictions for criminal or civil offenses, state or Federal.
Any information obtained through this record check will be used exclusively for the purpose of determining my eligibility for a security clearance to participate in the ATF Citizens Academy.
My consent is valid for one year from the date of my authorization appearing below.
I also understand that concealing a material fact on this application can be the basis for rejection of my application to the ATF Citizens Academy.
Printed Full Name
Required Field(s) Missing!