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Application

To be considered for participation in the District Attorney’s Citizen Prosecutor Academy, all applicants must be willing to commit to 10-12 sessions beginning in Fall 2013. Classes start promptly at 6:30 PM to 8:30 PM.

First Name*
Middle
Last*
Address*
City*
State*
Zip*
Date of Birth*
DL # *
Home Phone*
Format: 555-555-5555
Cell Phone
Email Address*
Employer
Work Phone
Occupation
How did you learn of this program
 DA Web site  College
 DA Facebook page  Colleague
 DA Twitter  Professional organization
 News source (newspaper, TV, radio, internet)  Other
Briefly state why you wish to participate in the Dallas County District Attorney's Citizen Prosecutor Academy
Briefly list any civic or professional organizations in which you are currently active
Do you: (check all that apply)
 Live in Dallas County - how long?
 Work in Dallas County - how long?
 Yes, I have an interest in Dallas County community events and activities?
EDUCATION

Please check all that apply 		 
 High School diploma  Technical/Trade school
 Undergraduate degree  Graduate degree
 I have other professional certifications

Schools attended
 
PERSONAL REFERENCES  
Name* Address*
Home Phone* Work Phone*
Relationship to Applicant*  
Name* Address*
Home Phone* Work Phone*
Relationship to Applicant*  
EMERGENCY CONTACT INFORMATION
Name* Address*
Home* Phone Work* Phone
Relationship to Applicant*  
Name* Address*
Home Phone* Work Phone*
Relationship to Applicant*  
Have you, your spouse, any family member or close personal friend ever been accused, arrested or convicted (including probation, deferred adjudication, conditional discharge, fine, etc.) of a crime above the level of a traffic ticket?*
  Yes No
If you answered yes, please provide the name of the person charged, relationship to you, type of crime, date of disposition.
Do you, your spouse, any family member or close personal friend currently have any pending criminal cases?*  Yes No

If you answered yes to either of the last two questions, you will not be automatically excluded from consideration; however, the information must be disclosed.

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

CERTIFICATION

  I represent and warrant the answers I have provided to each of the foregoing questions are complete and true to the best of my knowledge and belief.

 I further understand that the Dallas County District Attorney's Office will be conducting a thorough background investigation that may include, but is not limited to, criminal history, employment history, and personal references. I also understand that any participant may be removed from the Dallas County District Attorney's Citizen Prosecutor Academy if said participant is disruptive or otherwise inhibits the concept or implementation of this program.