ARIDE Registration Form
ARIDE Registration Form
(Please print clearly. This information will be used for your certificate and official records)
Personal Information
Name:
Last
First
MI
TCOLE PID:
Date of Birth:
Home Address*
Street or Box No
Advanced Roadside Impaired Driving
Enforcement
City
State
Zip
Work Phone:
Fax Number:
Cellular Phone
Email Address:
Peace officer Status: Full Time:
Reserve:
Cadet:
Other:
(if you are a peace officer, check the appropriate box. This is for your TCOLE records)
** Attach copy of TCOLE report showing 24 hr SFST course. Registration is not complete until we have report. Exceptions are Texas DPS and TX Park & Wildlife.**
Agency/ Company Information
Agency/Company Name: Agency Address:
Street or Box No
City
Job Title:
State
Zip
Course Information
Course Title ARIDE
Credit Hours: 16
Starting Date: 03/19/2019
Ending Date: 03/20/2019
Course Location: Texas DPS Tactical Training Center
810 CR 240 _______________ _ ___
Site Address
Florence
TX
City
State
76527 _____
Zip
Florence, TX March 19-20, 2019
For Official Use Only Received By: Date:
After completing application, please e-mail to aride@SHSU.edu or Fax to 936-294-3263
WALK-INS WILL NOT BE ACCEPTED
Signature:
Date: Sign:
................
................
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