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Last Name
First Name
MI
Preferred Name(for name tag/tent)
Officer/Deputy Corporal Detective Sergeant Lieutenant Captain Major Deputy Chief/Chief Deputy Chief/Sheriff Other Rank if other:
Title
PID#
Date Of Birth
() - Participant Phone
Participant Email
Gender: Female Male
Please inform us of any food allergies:
Education: Less than AA or 60 hours AA or over 60 hours Bachelor's degree Master's degree Terminal degree
Ethnicity: Black Indian Hispanic Asian White / Anglo
Date Appointed / Elected: Month / Year Previous Department Previous Position Name of person replaced
Is this your first time to serve as chief of police in Texas? Yes No If you are a first-time Texas police chief and have been appointed/elected after January 1, 1999, you are required to complete 80 hours of training within 24 months of your appointment/election: New Chief Development Program (40 hrs.) and Texas Police Chief Leadership Series (40 hrs.). Both classes are only offered by LEMIT.
Agency / Department
() - Agency Phone
Agency Email
Mailing Address
City
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Zip
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#FT Officers in Department
Course is $100 per person.
I will be paying by:
Online by Credit Card or Electronic Check Paper Check/Purchase Order (Check/PO # )
You will be contacted with payment information once the minimum number of attendees has been reached.
If no notice of cancellation is received by the Program Coordinator prior to the date of the program, and the participant does not attend the program, the participant or their agency will be required to pay a $100 'NO-SHOW' fee.
I have read and agree to the above policies.