Citizen Prosecutor Academy Application

Please read the application carefully for instructions.

Personal Information

First Name*

Middle Name*

Last Name*

Preferred Name

Date of Birth*

mm/dd/yyyy

Address*

Street or P.O. Box

City*

State

Zip Code*

Home Phone Number

555-555-5555

Cell Phone Number*

555-555-5555

Email Address*

johndoe@doe.com

Drivers License Number*

Drivers License Issuing State*

Employer Name*

N/A if Not Applicable or if you are retired please state "Retired" and list the Company or Business where you last worked.

Employer Address

Occupation*

Retired? Please state "Retired" and list your last occupation.

Work Phone Number

555-555-5555

Briefly list any civic organizations or activities in which you are currently involved:*

What do you hope to gain or experience during your participation in this program?*

How did you learn about this program?*

Do you:

Live in Collin County?*

Yes

If so, how long?

Work in Collin County?*

Yes

If so, how long?

Have an interest in Collin County community events and activities?*

Yes

If you do not live or work in Collin County, please describe your reasons for wanting to participate in this program:*

EDUCATION

Please list your educational background:*

PERSONAL REFERENCES

Two personal references not related to you are required.

Name*

Full Name

Address*

Street, City, State, Zip Code

Relationship to Applicant*

Home Phone Number*

Work Phone Number

Name*

Full Name

Address*

Street, City, State, Zip Code

Relationship to Applicant*

Home Phone Number*

Work Phone Number

EMERGENCY CONTACT INFORMATION

In the event of an emergency, we will contact the person you have listed here for that purpose.

Name*

Full Name

Address*

Street, City, State, Zip Code

Relationship to Applicant*

Home Phone Number*

Cell Phone Number*

Work Phone Number

Police Contact

Have you ever been arrested in Texas, or any other state?*

Yes

If you answered yes, please provide the state in which the arrest occurred, details of the arrest, including the date and disposition.*

N/A if Not Applicable

Does any family member have a pending criminal charge?*

Yes

If you answered yes, please provide details of the charge, including whether the family member is currently placed on regular or deferred probation.*

Type "N/A" if not applicable.

Social Media

List user name/handle for each social media site. Type "N/A" if not applicable.

Facebook

Instagram

Twitter

Snapchat

TikTok

Threads

List user name/handle for other social media sites not listed above:*

Type "N/A" if not applicable.

Please review your answers carefully and read the following statement before submitting this application!

CERTIFICATION: I hereby certify that there are no willful misrepresentations, omissions, or falsifications in the foregoing statements and answers to questions. I understand that any omission or false statements on this application shall be sufficient cause for rejection for enrollment or dismissal from the Collin County Criminal District Attorney’s Citizen Prosecutor Academy. I further understand that the Collin County Criminal District Attorney will be conducting a thorough background investigation that may include, but is not limited to, criminal history, employment history, and personal references. I declare that I have never been convicted of a felony offense in this state, any other state, or the United States. I also understand that any participant may be removed from the Collin County Criminal District Attorney’s Citizen Prosecutor Academy if said participant is disruptive or otherwise inhibits the concept or implementation of this program.

Signature*

Clear

Please upload a copy of your driver's license*

Maximum upload size: 536.87MB

Please upload a headshot photo*

Maximum upload size: 536.87MB

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