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Arkansas Safe Schools Conference
Registration
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Who are you?
*
Required
Course Name
*
Required
Course Date
*
Required
Course Location
*
Required
Rank/Title/Position
*
Required
First Name
*
Required
Middle Initial (if you have no middle initial, enter NMI)
*
Required
Last Name
*
Required
Nickname/Preferred Name
Email
*
Required
Would you like training schedule notifications emails sent to you?
Yes
No
CLEST-ID Number (Required for Arkansas Commission on Law Enforcement Standards & Training (CLEST) reporting if you are Arkansas LE.)
Phone
*
Required
Alternate/Evening Phone Number
Employer
*
Required
Employer Address
*
Required
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Employer Phone/Extension
Employer Fax
Are you Sworn or Non-Sworn?
*
Required
Sworn
Non-Sworn
Position Type (Select all that apply)
*
Required
Law Enforcement
Correctional Officer
Detention Center Employee
Jailer
Part-Time I
Part-Time II
Auxiliary
Educator/School Staff
Other
If you selected other, What is your position?
How did you hear about this class?
Internet Search
Email
Fax
Facebook
Twitter
Policetraining.net
Referral
Other
If you selected "Other" above, how did you hear about this class?
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Upload Signed & Dated Verification
Max. file size: 256 MB.
"Registrants must provide a signed and dated verification letter on agency letterhead with this submission. This letter will verify that I, (name of registrant), am an employee of (agency name) and hold the position of (sworn/non-sworn) (position title), located at (address) and have registered for (name of class) on (date). Multiple registrations from the same agency can be submitted on one letter. Verification letters remain on file for one year from the submission date and will be used to verify future registrations. If document upload is not possible, registrants can also fax a signed and dated verification letter on agency letterhead to 501-565-3081. The verification letter must be received within five days."
LAW ENFORCEMENT/CORRECTIONS PERSONNEL ONLY. Please complete the following information. (THESE ARE NOT REQUIRED)
Training Officer's Rank First Last Name
Training Officer's Phone Number/Extension
Training Officer's Email Address
How many sworn officers are in your agency?
Population Served
Type of Agency
Hidden
I Agree
*
Required
Yes, I agree.
Fee based classes: To confirm a slot in the class, payment must be received no later than three weeks prior to the start date of the course and registrants must fax a signed and dated verification letter on agency letterhead within five days of submission of registration request form to 501-565-3081 which includes the following statement: This letter will verify that I, (name of registrant), am an employee of (agency name), and hold the position of (sworn/non-sworn) (position title), located at (address) and have registered for (name of class) on (date). Your registration will be verified and you will receive separate notification (within 5 working days) of your acceptance into the course, as well as payment information. Please do not make any travel plans until you receive your acceptance notification. Free classes: Registrants must fax a signed and dated verification letter on agency letterhead within five days of submission of registration request form to 501-565-3081 which includes the following statement: This letter will verify that I, (name of registrant), am an employee of (agency name), located at (address) and have registered for (name of class) on (date). Your registration will be verified and you will receive separate notification (within 5 working days) of your acceptance into the course.
Name
This field is for validation purposes and should be left unchanged.
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