CPTED - January 4th, 5th & 6th, 2021

First Name: *   Last Name:  *    

       PID #:     (if PID is unknown or you never had one - just leave blank)

      Agency:

   Address: 

        City:     State:       Zip Code: 
 
        Work phone: 

                   Cell:  *  (In case the instructor needs to contact you during the class week)

                E-Mail: *


PLEASE CHECK ALL THAT APPLY:

       Student is a Texas Peace Officer, Licensed

       Student is a Licensed Telecommunicator

       Student is elected, not licensed

       Student is a County Jailer

       Student is a civilian and needs TCOLE training credit

       Student is a civilian or does not need TCOLE Training credit
    
       Yes, I have a special needs request, Dietary / Accessibility, etc.
               Please explain:

      My agency/company requires an invoice/billing before they will prepare a payment

     I am bringing a check ($250  $150) with me

     I will be paying by credit or debit card ($150 + 4.79 credit card fee) when I arrive for the training.

     I will be paying online, a $8.00 $4.79 credit card fee will be added, Total $258.00  $154.79    

     I understand that I should bring a laptop to use during class
                 (The student manual will be available for Download at the beginning of the first class.)

PLEASE SUBMIT THE FILLED-IN REGISTRATION FORM ABOVE,

If your registration form was processed successfully you will be
returned to this page.
STOP - do not continue until you send the registration Form
If you have completed and submitted your registration form above  and
wish to pay online now (There is a $7.50 credit card processing fee)
you may click this Pay Now button:  

If you have completed the "Pay Now" button process and are returned to this page,
a paid Invoice/Receipt will be given to the student when they arrive to begin class.

Any questions or concerns please call our AACPA Treasurer, Don Carr 210-659-2710 (24/7).