Special Operations Group

Training Course Application

(print this for mail or fax delivery)

14324 telegraph Road, Whittier, CA 90604

(562) 906-9848 fax (562) 906-6918

Name:
Address:
City: State: Zip Code:
Country: Country of Citizenship:
Phone #: Fax #: Other #
Email address:
Employer: Position:
Person to contact in case of emergency: Phone #:
Any Physical Limitations:
STATEMENT OF NO CRIMINAL RECORD, METAL ILLNESS, SUBSTANCE ABUSE
By my signature on this application, I state that I have no criminal convictions that would prohibit me from possessing a firearm including the crime of domestic violence, am not currently under indictment or prosecution for any offense, and am not wanted for questioning or arrest by any law enforcement or government agency. I further state that I have no history of mental illness or substance abuse. I understand that my training may be terminated at any time during the course if my actions are not deemed appropriate by Special Operations Group or their sponsors. SIGNATURE:____________________________________________ DATE:_______________________________
NAME OF COURSE	DATE	PRICE
1.
2.
3.
4.
Other items to be charged:
1.
2.
3.
	TOTAL

METHOD OF PAYMENT

Money Order ˜ Check ˜ Credit Card ˜ Purchase Order ˜ Please Invoice my Employer ˜

Please charge by : Visa ˜ Master Card ˜ American Express ˜ Discover ˜

Name on Credit Card:

Credit Card #: Expiration Date:

Signature for Credit Card Authorization:

Make all methods of payment made payable to : Special Operations Group

ONE APPLICATION PER STUDENT

We must receive a copy of your peace officer or military identification to attend any law enforcement courses.  Include a copy of your identification with this application or present your identification on the course date. Security personnel must provide a copy of your guard and firearms permit along with your identification.