Texas Department of Public Safety
Course Information
|Course Title |Course Date(s) |No. of Students |Tuition (per student) |
| | | |$ |
|GRAND TOTAL |$ |
Agency Information
|Point of Contact (Rank/Title, Name): |
|Agency Name: |
|Mailing Address: |City, State: |ZIP: |
|Phone No.: |Fax No.: |Email Address: |
|How did you hear about this course? DPS Website Email Flyer TPA Website Other |
Student Information
|Student 1 | Commissioned Non-Commissioned |
|Rank/Title: |First Name: |Last Name: |
|Student 2 | Commissioned Non-Commissioned |
|Rank/Title: |First Name: |Last Name: |
|Student 3 | Commissioned Non-Commissioned |
|Rank/Title: |First Name: |Last Name: |
|Student 4 | Commissioned Non-Commissioned |
|Rank/Title: |First Name: |Last Name: |
Payment Information
|Select method of payment: | Check (Payable to: Texas Police Association) Credit Card |
|Select card type: | MasterCard VISA Discover |
|Credit Card No.: |Expiration Date: / |Security Code (back of card): |
|Name on Card: |
|Signature: |Date: |
Please submit this registration form via:
Email: DPS.Training@dps.
Fax: (512)424-5734
Mail: Texas Department of Public Safety, Law Enforcement Education, MSC 0252, PO Box 4087, Austin, TX 78773-0252
For more information, please visit DPS/TPA websites or contact Training staff:
txdps.state.tx.us
(512)424-7214
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