Level III Application Form

M.A.S.I. SCHOOL
TX DPS Private Security Bureau License #C20189, F15818101, Y15797901

134 Vintage Park Blvd; Suite A206; Houston, Texas 77070
Application Form

Level III Security Training
I,First Name* Last Name* hereby apply for admission on this date Date*.
I respectfully request that the faculty evaluate my prior academic training and other qualifications to enter the program at the level that I indicate below:
Level 3 Training Course, 45 Hours
APPLICANT'S PERSONAL INFORMATION
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Social Security #*
In which state do you make your permanent residence?*
Driver's License Number *
State*
Do You Currently Have Any Security License*
Are you a U.S. Citizen?

YesNo
If not a U.S. Citizen, and you are taking Level II, please provide Immigration Status
I understand this will cost me $blanks, which is non-refundable.
I understand that I am enrolling in the private security course - Texas - Level III Commissioned Officer Training Course(s) and that the cost of the course is (non-refundable). I further understand that I am taking the above course(s) free of coercion and in order to gain knowledge in the field of Texas Private Security. I understand that my taking this course does not bind or obligate security agencies to hire me in any form or represent that I will be hired with any agency in any form. I also understand that this course will not license me as a Security Officer. The course material shall be prepared by and obtained from the department. A certificate indicating completion of Level III training including gun range training shall be submitted to the department along with the application to license the individual. (45) classroom hours shall be offered by department approved instructor.
Signature*

Clear
Date*

MonthDayYear
Date
M.A.S.I. School

134 Vintage Park Blvd Suite A206 Houston, TX 77070 Phone 713.259.5812 EMAIL: INFO@MASISCHOOL.COM
www.MASIschool.com
Should be Empty:

M.A.S.I. SCHOOL

Application Form

APPLICANT'S PERSONAL INFORMATION

M.A.S.I. School