2. Selection and notification of participants will be completed by December 30. There is no requirement for participants to engage in volunteer activities of the Police Department.

   If you prefer to print a hard copy of your application, please return it to: Ponca City Police Department, ATTENTION NANCY BRICKER, 200 East Oklahoma, Ponca City, OK 74601.
4. First Name
5. Last Name
7. Address1
9. City
10. State
11. Zip
13. Driver License #*
15. Daytime Phone*
16. Evening Phone*
18. Email Address*
20. Do you have a felony conviction?*

    1. Yes
    2. No
21. Have you been convicted of Domestic Violence?*

    1. Yes
    2. No
23. Will you be able to attend all training sessions?*

    1. Yes
    2. No
24. Do you know any of the previous attendees?*

    1. Yes
    2. No
26. Why do you want to attend the Academy?*
28. If yes, who do you know?
Leave This Blank:


30. Submit Submit and Print

* indicates a required field