Clone of EOT | Stage 5 | EOT Course Seat Confirmation

SECTION 1: APPLICANT IDENTIFICATION
1. Full Legal Name

First NameMiddle NameLast Name
2. Email Address

Confirmation EmailMust match the email used during payment/registration
3. Phone Number
Please enter a valid phone number. Include area code.Format: (000) 000-0000.
4. Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
5. Is your mailing address the same as your physical address? (We use this to mail your certificate).
5-A. Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
6. GovSource Ticket ID (Optional)
Only if Form-76 was issued by GovSource
SECTION 2: DOCUMENT UPLOAD INSTRUCTIONS
All required documents must be uploaded as CLEAR scanned copies.

You may use a mobile scanning app (such as Notes, Adobe Scan, or CamScanner) to convert photos into a PDF.

Submitting scanned copies removes the need to mail original documents.

Blurry, incomplete, or improperly scanned images may delay your seat confirmation.
SECTION 3: REQUIRED DOCUMENT UPLOADS
7. Upload Driver’s License (Front and Back)

Upload both front and back as clear images or a single PDF
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8. Which FDLE Selection Center issued your CJSTC-76 Form?
Choose the Selection Center from the approved list.
9. Upload CJSTC Form-76

Must be fully completed and signed
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SECTION 4: LAKE TECH REQUIRED DOCUMENTS
10. Upload Lake Tech: Part-Time Registration Sheet

Must be signed by the candidate
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11. Upload Lake Tech: Affidavit of Applicants – Addendum

Must be signed and notarized
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12. Upload Lake Tech: Agreement Form and Liability Waiver

Must be signed and notarized
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SECTION 5: SUBMISSION STATUS
13. Document Submission Status
Select your current submission type
14. What course track are you registering for?
15. Choose the EOT Course Date you wish to attend.
16. Would you like to be placed on a stand-by list for already filled courses? (Optional)
SECTION 6: HOTEL ACCOMMODATION (HILTON PARTNER)
We partner with the Hilton Group (Hampton Inn) to provide preferred rates for EOT students
17. Would you like assistance with hotel accommodations?
SECTION 7: HOTEL DETAILS (CONDITIONAL – SHOW ONLY IF YES)
18. Check-In Date

MonthDayYear
Select your anticipated arrival date
19. Check-Out Date

MonthDayYear
Select your anticipated departure date
20. Room Preference
Subject to availability through hotel partner
21. Special Requests or Notes
Optional (late check-in, accessibility needs, etc.)
Consent to Share Information with Hotel Partner
SECTION 8: CERTIFICATION & AGREEMENT
Should be Empty:

SECTION 1: APPLICANT IDENTIFICATION

SECTION 2: DOCUMENT UPLOAD INSTRUCTIONS

SECTION 3: REQUIRED DOCUMENT UPLOADS

SECTION 4: LAKE TECH REQUIRED DOCUMENTS

SECTION 5: SUBMISSION STATUS

SECTION 6: HOTEL ACCOMMODATION (HILTON PARTNER)

SECTION 7: HOTEL DETAILS (CONDITIONAL – SHOW ONLY IF YES)

SECTION 8: CERTIFICATION & AGREEMENT