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Tuesday, May 22, 2012
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San Bernardino Citizen's Academy Application
San Bernardino Citizen's Academy Application
Name
Residentail Address
City, State, Zip
Main Phone
Alternate Phone
* Email Address
* Date of Birth (mm/dd/yyyy) (required)
All potential applicants are screened before they are selected to SBCA.
This consists of a minimal background check, mainly to be sure that no participants have outstanding warrants.
Hobbies or Special Interests
How Long Have you been a resident of San Bernardino?
Are you currently registered to vote?
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Yes
No
Ward? (if known)
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1
2
3
4
5
6
7
Occupation and Employment?
Community and/or civic groups of which you are affiliated?
Groups
Why would you like to participate in the San Bernardino Citizen’s Academy?
Why
What are your opinions about the City of San Bernardino?
Opinions
What particular questions would you like to have answered regarding our city?
Questions
Security Word
Please enter the word above in the space below
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