Charisma SPD – Security Guard Training Application

1
Are you enrolling for New Training or Renewal?* This field is required.
New Training
Renewal
2
Which NYS track are you applying for?* This field is required.
Unarmed Security Guard
Armed Security Guard (Firearms)
Not sure (help me choose)
3
Preferred training format* This field is required.
In-Person
Online/Remote (if available)
Hybrid
4
Preferred training schedule* This field is required.
Weekdays
Weekends
Evenings
Flexible
5
Preferred location* This field is required.
Bronx/NY area
Other (Specify)
6
Preferred location (city/state)* This field is required.
7
Are you 18 years or older?* This field is required.
Yes
No
8
You must be 18+ to enroll. (Form will end here if under 18)
9
Full Legal Name* This field is required.
First Name
Last Name
10
Preferred Name
11
Phone Number* This field is required.
Please enter a valid phone number.
12
Email* This field is required.
example@example.com
13
Date of Birth* This field is required.
Date
Month
Day
Year
14
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
15
Preferred contact method* This field is required.
Call
Text
Email
16
Emergency Contact Name* This field is required.
17
Emergency Contact Relationship* This field is required.
18
Emergency Contact Phone* This field is required.
Please enter a valid phone number.
19
Are you authorized to work in the U.S.?* This field is required.
Yes
No
20
Will you require sponsorship now or in the future?* This field is required.
Yes
No
21
Upload Government-issued Photo ID (PDF, JPG, PNG)* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.0MB
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22
Upload Proof of Address (PDF, JPG, PNG)
Drag and drop files here
Select files to upload
Max. file size: 10.0MB
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23
Do you have a Social Security Number?* This field is required.
Yes
No
24
Last 4 digits of SSN* This field is required.
25
Reason/Status* This field is required.
26
Select ALL training/certificates you want (choose all that apply)* This field is required.
8-Hour Pre-Assignment (New)
16-Hour On-the-Job Training (OJT)
8-Hour Annual In-Service (Renewal)
47-Hour Firearms Training (if applicable)
CPR / AED
First Aid
De-escalation / Conflict Resolution
Customer Service & Professional Conduct
Report Writing & Documentation
Workplace Safety / OSHA Basics
Other
27
Other training requested* This field is required.
28
Is this registration/renewal time-sensitive?* This field is required.
Yes, urgent (within 7 days)
Yes, within 2–3 weeks
No, within 1 month+
Not sure
29
Have you ever held a Security Guard registration before?* This field is required.
Yes
No
30
Registration number (if known)* This field is required.
31
State* This field is required.
32
Prior security experience?* This field is required.
Yes
No
33
Describe experience (company, role, dates)* This field is required.
34
Education level* This field is required.
Please Select
Please Select
High School or GED
Some College
Associate Degree
Bachelor's Degree
Master's Degree or higher
Other
35
Any schedule limitations?
36
Do you need job placement assistance after training?* This field is required.
Yes
No
37
Current NYS Security Guard registration number* This field is required.
38
Registration expiration date* This field is required.
Date
Month
Day
Year
39
Which renewal requirement are you completing?* This field is required.
8-Hour Annual In-Service
Other
40
Please specify other renewal requirement* This field is required.
41
Upload current/previous training certificate(s) (PDF, JPG, PNG)* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.0MB
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42
Have you completed annual training within the last 12 months?* This field is required.
Yes
No
43
Explain your situation / last training date* This field is required.
44
Do you have a valid pistol permit?* This field is required.
Yes
No
45
Upload pistol permit (PDF, JPG, PNG)* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.0MB
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46
Prior firearms training?* This field is required.
Yes
No
47
Upload firearms training proof (PDF, JPG, PNG)* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.0MB
Cancelof
48
How will you pay?* This field is required.
Self-pay
Employer-sponsored
Other
49
Employer/Company name* This field is required.
50
Employer contact name* This field is required.
51
Employer contact email* This field is required.
example@example.com
52
Employer contact phone* This field is required.
Please enter a valid phone number.
53
Do you need an invoice/receipt?* This field is required.
Yes
No
54
Billing email* This field is required.
example@example.com
55
Attendance Policy: All students are required to attend all scheduled training sessions and present a valid government-issued photo ID at check-in. Reschedule and refund requests must be made in advance and are subject to program policy.
56
I certify the information provided is true and complete.* This field is required.
I agree
57
I understand completion requires attendance and meeting course requirements.* This field is required.
I agree
58
I authorize Charisma SPD to contact me by phone/text/email about enrollment and scheduling.* This field is required.
I agree
59
I acknowledge the refund/reschedule policy.* This field is required.
I agree
60
Electronic Signature* This field is required.
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61
Date Signed* This field is required.
Date
Month
Day
Year
62
Anything else you want us to know?
Should be Empty: