Narcotic and Specialized Unit Supervisor Course
Monday, September 17 - Friday, September 21, 2018
8:00 AM - 5:00 PM
Location: Humphrey's Half Moon Inn & Suites
Directions: 2303 Shelter Island Drive, San Diego, CA 92106

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DO NOT FILL OUT IF YOU ARE OUT OF STATE
PLEASE FAX OR EMAIL YOUR REGISTRATION FORM

STUDENT INFORMATION * Required
First Name:
*

Last Name:
*

Middle Name:*

Position/Title/Rank:
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Permanent Address: (no P.O. Boxes)*


Address 2

City:*

State:*
Zip Code:*

CONTACT INFORMATION
Phone Work: (include area code)
*

Cell Phone: (include area code)


E-mail:
*

(Please Use Law Enforcement Agency Email Address)

IDENTIFYING INFORMATION *
Sworn Law Enforcement Officer

Post ID#:

Date of Birth (mm/dd/yy):*

(For College Credit)

Age:*

Birth City:*
 

Birth State or Country:*

Last 4 digits of social security #  
Gender* Male Female


Previous Last Name (enter N/A if the same):
*


HIGH SCHOOL LAST ATTENDED*
Name of High School*

County (if California)*

State or County (If NOT California)*

Years Attended*
-
Year Graduated*

High School Graduation Status*

WHEN DID YOUR PRESENT STAY IN CALIFORNIA BEGIN?*
Approximate date you arrived in California (mm/dd/yy)*

YOUR AGENCY / ORGANIZATION NAME*



HIDTA TASKFORCE MEMBER

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PRICE: $365

Members and Non-Members

 Law Enforcement Credentials Are Required at Registration

CANCELLATION POLICY:  Cancellations and requests for refunds must be received in writing.

Cancellations received prior to August 27, 2018 will be charged a $35 cancellation fee.

Registrations canceled after August 27, 2018, and "no-shows" will not be refunded

Substitutions will be accepted through September 17, 2018.

Cost per person: $365

Credit Card Information (all fields required)
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Cardholder's First Name

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Credit Card Number

Exp Date
(e.g.: 05/2019)
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Cardholder's Billing Street Address

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Billing Zip Code

Billing Country
(2-digit country code)

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