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2. First name*
3. Middle name*
4. Last name*
6. Date of birth*
   Date of birth
7. Your school (if attending school)
   -- Select One --Lakeville North High SchoolLakeville South High School
9. Street address*
10. City*
12. State*
13. ZIP code*
15. Phone number*
16. Email address*
18. Do you have an interest in law enforcement as a career?*

    1. Yes
    2. No
20. Are you interested in public safety as a career outside of law enforcement?*

    1. Yes
    2. No
22. Are you interested in criminal justice as a field of study?*

    1. Yes
    2. No
24. Acknowledgement*

    By clicking on the “Accept” button, I hereby certify that all information I have provided in this application is true and complete to the best of my knowledge. I also agree that falsified information or significant omissions on the application may disqualify me from further consideration.

    1. Accept (this serves as my electronic signature)
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26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field