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2. Participant Information
4. First Name*
5. Middle Initial
6. Last Name*
8. Address Line 1*
10. Address Line 2
12. Stonecrest
13. GA
14. Zip Code
16. Address Type*

    1. Home
    2. Business
18. Email*
19. Phone*
21. Eligibility & Attendance
    • Applicants must be a Stonecrest resident or a Stonecrest business owner.
    • To complete the application process, applicants will need to bring a government-issued ID and a printed copy of the completed application to City Hall. (If the ID does not have a Stonecrest address, then the business license should be presented.)
    • Applicants must commit to attending all sessions, including orientation and graduation. (Maximum of 1 excused absence with a makeup opportunity available). Orientation and Graduation attendance are required.
    • Applicants must be at least 18 years old.
    • Applicants must have an interest in learning about the City of Stonecrest.
23. Please check all that apply.*

    1. I am a resident of Stonecrest.
    2. I own a business in Stonecrest.
24. Name of Business (if checked in previous question)
26. Can you attend all scheduled sessions?*

    1. Yes
    2. No
27. If no, which session will you be unable to attend?
29. How long have you lived in or owned a business in Stonecrest?*
31. Questions
33. Why do you wish to participate in Citizens Academy?*
35. Which service or government function are you most interested in learning more about?
37. Please list any community involvement in the past 5 years:
39. Have you participated in a previous Citizens Academy program? (Note: With limited seating, preference is given to new applicants.)*

    1. Yes
    2. No
41. Emergency Contact

    In case of emergency, who should we contact?

43. First Name*
44. Last Name*
46. Phone*
47. Relationship to you*
49. Polo Shirt Size*
    -- Select One --SMLXL2X3X4X5X
51. Authorization

    By signing below, you agree to the program requirements and attendance policy and that you will attend the orientation and graduation. You understand that the course roster is filled on a "first-come, first-serve" basis, and that your application does not guarantee you a slot in the program. You understand that all information in this application, and all information furnished in support of this application, is given for the purpose of obtaining admission into the City of Stonecrest Citizens Academy Program. You agree that the information stated in this application is true to the best of your knowledge.

53. Consent*

    1. I agree
55. Type Name (Signature)*
Leave This Blank:


59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field