Full Name:
Date of Birth:  Month:   
Home Address:
City:       State:      Zip:
Home Phone:
Cell Phone:
School: Grade:
Email Address:
Teacher Name:  
Teacher Email:  
Drivers License:
I would like to join the Teen Academy because...
By clicking Submit you are confirming that all the information listed in the application is true and correct, UNDER PENALTY OF PERJURY. All applicants will have a background check as part of the application process. All submissions are logged and their IP address. Applications are processed on a first come, first served, basis. Submittal of an application is not a guarantee of acceptance into the Teen Academy program. For more information, or to confirm class availability, contact the Riverside Police Department Public Education unit at (951) 826-5235.