Dothan: September 19-20

Registration Form - Dothan Alabama September 19-20

Fill out the form carefully for registration
Name *

First Name Last Name
E-mail Address *
Personal Phone Number *
Agency *
Are you an active 911 dispatcher? *
Enter either (y or n)
How many years? *
Example: 10
Are you a Chaplain attached to a law enforcement agency? *
Enter either (y or n)
Who appointed/hired you? *
Are you a licensed mental health professional? *
Enter either (y or n)
Please provide your certification level, license #, three references (preferably law enforcement), and a brief biography along with why you want to work with law enforcement. *
This ALLEAPS course is restricted to Law Enforcement Officers, Chaplains, and Licensed Mental Health professionals.

You do not meet the minimum requirements for this course.
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Registration Form - Dothan Alabama September 19-20