DO NOT FILL OUT IF YOU ARE OUT OF STATEPLEASE FAX OR EMAIL YOUR REGISTRATION FORM
STUDENT INFORMATION * RequiredFirst Name:* Last Name:* Middle Name:* Position/Title/Rank:* Permanent Address: (no P.O. Boxes)* Address 2 City:*
CONTACT INFORMATIONPhone Work: (include area code)* Cell Phone: (include area code) E-mail:* (Please Use Law Enforcement Agency Email Address)IDENTIFYING INFORMATION * Sworn Law Enforcement OfficerPost ID#:Date of Birth (mm/dd/yy):* (For College Credit)
Birth State or Country:* Last 4 digits of social security # Gender* Male FemalePrevious 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*Received HS DiplomaNot HS Graduated or StudentGED EquivalencyProficiency ExamForeign DiplomaConcurrently EnrolledAdult SchoolSelect
YOUR AGENCY / ORGANIZATION NAME*
HIDTA TASKFORCE MEMBER
Members and Non-Members
Law Enforcement Credentials Are Required at RegistrationCANCELLATION 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 refundedSubstitutions will be accepted through September 17, 2018.