January 9-12, 2023 Tuscaloosa

...Registration Form - Tuscaloosa, Alabama... January 9-12, 2023

Fill out the form carefully for registration
Name*

First NameLast Name
E-mail Address*
Personal Phone Number*
Agency*
Are you an active or retired sworn peace officer?*
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.
Should be Empty:

...Registration Form - Tuscaloosa, Alabama... January 9-12, 2023