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Brewster Police Department
Citizens Police Academy
Application
Class Starts 10/15/2019-12/17/2019
Classes will be held on Tuesday 6-8:30PM
Name:____________________________________________________________
Address:________________________________________________________________
SS#_____________________________________________Date of Birth:____________
Home Phone:_________________________Work Phone:_________________________
Email:__________________________________________________________________
Occupation:______________________________________________________________
Why do you wish to attend the Brewster Police Department Citizens Police
Academy?__________________________________________________________
I authorize the Brewster Police Department to conduct a criminal history check for the
purpose of making a determination of eligibility for the Citizens Police Academy.
Signature:___________________________________________Date:________________
If you have any questions please contact Lieutenant George A. Bausch at the
Brewster Police Department 508-896-7011.
gbausch@brewster-ma.gov