Child's Name (First):
Child's Name (Last):
Date of Birth (mm/dd/yy):
Name of Parent or Guardian (First):
Name of Parent or Guardian (Last):
Confirm Email Address:
Emergency Contact Name:
Emergency Contact Phone:
Select the week you wish to attend:
Week 1: Malden, Woburn, Billerica, Wakefield (Week of July 7 - July 11, 2014)
Week 2: Burlington, Arlington, Medford, Belmont (Week of July 14 - July 18, 2014)
Week 3: Cambridge, Ashland, Framingham, Natick (Week of July 21 - July 25, 2014)
Week 4: Lowell, Tewksbury, Chelmsford, Wilmington (Week of July 28 - August 1, 2014)
Week 5: Tyngsborough, Bedford, Watertown, Waltham (Week of August 4 - August 8, 2014)
Week 6: Acton, Hudson, Maynard, Westford (Week of August 11 - August 15, 2014)
Will you have a need for consideration for one of the limited number of scholarships?
Has your child previously attended the YPSA:
Child's T-Shirt Size:
Once your application has been submitted, you will be contacted by a member of the YPSA staff via email regarding the status of your child's application.
The fee for the YPSA is $75.00 per child. Upon acceptance to the YPSA, the staff will follow up with parents/guardians regarding payment and supplemental forms. Participants must be 9-11 years old. Lunch and snacks are provided. A graduation ceremony is held on the last day of your child's week; at least one parent or guardian is required to attend the graduation ceremony/cookout. The Cadets will be picked up each morning at 8:00am in their community at a designated location and will be dropped off at the pick up site at approximately 2:45-3:00pm each day (the exception being Friday when parents attend the graduation ceremony and cadets accompany them home). A staff member will be at the pick up site to ensure each cadet is picked up by a parent or guardian.Due to the close proximity of the YPSA to Burlington and Billerica, there will not be a bus stop for these two communities. Parents/Guardians will drop-off and pick-up the Cadets at the YPSA (793 Boston Rd. Billerica).All information on this application is confidential.Thank you for applying to the Middlesex Sheriff's Office Youth Public Safety Academy. Reminder, this is only an application and does not indicate the acceptance of your child. The staff of the YPSA will follow up with you regarding the status of your application.
I have read and understand the requirements in the above statement:
793 Boston Road, Billerica, MA 01821
Phone: 978-932-3266 ~ Fax: 978-528-2196