23rd CITIZEN’S CRIMINAL JUSTICE ACADEMY
January 12 – March 15, 2012
PALM BEACH COUNTY CRIMINAL JUSTICE COMMISSION
Governmental Center, 10th Floor, Suite 1001
301 N. Olive Avenue
West Palm Beach, Florida 33401
Tel: (561) 355-4943 Fax: (561) 355-4941
(Registration form can be faxed, mailed or e-mailed)
Last First Middle
(Please print your name below as you wish it to appear on your certificate of completion)
City State Zip County
(H) (W) (C) (FAX)
Preferred method of contact: Phone Fax E-mail
Please indicate whether you have any special requirements
How did you hear about the academy?
Note: Class meets Thursdays from 6:00 – 9:00 p.m.