Course Registration

Course Name*

Rank/Title/Position*

First Name*

Last Name*

Nickname/Preferred Name

Email Address*

CLEST-ID, if applicable. If not, enter the last 4 of SSN*

Date of Birth*

Cell Phone Number

Employer*

Employer Address*

Employer Phone Number*

Employer Fax Number

Are you Sworn or Non-Sworn?*

Sworn

Non-Sworn

If "Other", what is your position type?

Training Officer's Rank, First, and Last Name*

Training Officer's Phone Number/Extension*

Training Officer's Email Address*

How many sworn officers are in your agency?

10 or less

11-20

21-50

51-99

100-249

250 or more

Does not apply

Population Served

1 - 2,500

2,501 - 10,000

10,001 - 25,000

25,001 - 50,000

50,001 - 75,000

75,001 - 100,000

100,001 - 500,000

500,001 or more

Does not apply

Type of Agency

Municipal

County

State

Federal

Does not apply

How did you hear about this class?*

Internet Search

PoliceOne.com

Email

Facebook

Referral

CLEST

Other

If you selected "Other" above, how did you hear about this class?