Level IV Security Training

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 IV 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 IV Training Course, 15 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 IV Security Training, 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 IV Personal Protection 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 Personal Protection Officer. The course material shall consist of a minimum of fifteen (15) classroom hours and shall be offered by department approved personal protection officer training schools and taught by department approved personal protection training instructors. All training shall be conducted with a department approved instructor present during all instruction. All students of a personal protection officer training course shall be tested with an examination prepared by and obtained from the department. A certificate indicating completion of Level IV training shall be submitted to the department along with the application to license the individual.
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
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M.A.S.I. SCHOOL

Application Form

APPLICANT'S PERSONAL INFORMATION

M.A.S.I. School