City of Benbrook
911 Winscott Road
Benbrook, TX 76126
(817) 249-3000
(817) 249-0884 fax

COPS Application

Instructions: Please complete this form and forward it to the Benbrook Police by pressing the "Submit Application" button at the bottom of the page.  A COPs Coordinator will contact you.  Thank You.

Contact Information:

Last Name:
 First Name:
Date of Birth:
E-mail
Address:
Apt #:
City:
State:
Zip Code:
Home Phone:
Alt. Phone:
Occupation:
Work Phone:
Ext:
Pager:
Mobile:

     

Why do you wish to attend the Academy?

 

Have you ever been arrested for or convicted of a crime?      YES          NO

If so, please explain:

Provide names, addresses, and phone numbers of two personal references:

Please write other comments, information or questions below.


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