Teen CPA Application

HOW DO I APPLY?

To participate in our upcoming Teen CPA, please complete and submit the application form below. The class fills up quickly and seats are reserved on a first come, first served basis. Space is limited.

If you have any questions about the program, the application, or other inquiries, please contact:

Tim Petropulos | Police Sergeant

Irvine Police Department | Youth Services Unit

TPetropulos@cityofirvine.org | 949-724-7015

Erin Brennan | School Resource Officer

Irvine Police Department | Youth Services Unit

EBrennan@cityofirvine.org | 949-724-7212 x2026

Tanya Ayalde | School Resource Officer

Irvine Police Department | Youth Services Unit

TAyalde@cityofirvine.org | 949-724-7181

Thank you for your interest in our program!

FIRST NAME

LAST NAME

DRIVER'S LICENSE (if applicable)

DRIVER LICENSE STATE

DATE OF BIRTH

RESIDENTIAL ADDRESS

CITY

STATE

ZIP CODE

HOME PHONE

CELL PHONE

HIGH SCHOOL NAME

LAST GRADE LEVEL COMPLETED

PARENT/GUARDIAN NAME

PARENT/GUARDIAN CONTACT NUMBER

PARENT/GUARDIAN EMAIL

PLEASE PROVIDE THE REASON YOU ARE INTERESTED IN OUR PROGRAM.

PLEASE INDICATE BY CHECKING ONE OR MORE OF THE BOXES BELOW HOW YOU HEARD OF OUR PROGRAM:

Friend

Police website

Police employee

Community event

Former CPA student

Flyer

Other

IF YOU ARE NOT A STUDENT OR RESIDENT OF IRVINE, PLEASE SHARE YOUR CONNECTION TO THE CITY (I.E. IF YOU WORK, ATTEND A RELIGIOUS INSTITUTION, PLAY A SPORT, VISIT FAMILIY, ETC.).

PLEASE PROVIDE ALL INSTANCES YOU WERE CONTACTED EITHER DIRECTLY OR INDIRECTLY, AT HOME OR SCHOOL BY LAW ENFORCEMENT WITHIN THE LAST THREE (3) YEARS.