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2. Name*
3. Address*
5. City*
6. Zip*
8. Phone*
9. Email*
11. Date of Birth
    Date of Birth

    Date of Birth
13. How long have you lived in Okaloosa County? *
15. Briefly explain why you wish to be enrolled in the FWB Police Department's Citizens Police Academy.*
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17. 1. Receive an email copy of this form.
18. Email address

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19. Submit

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