P O Security Training

ALABAMA PROFESSIONAL SECURITY TRAINING ACADEMY

(APSTA)

REGISTRATION FORM

(Please Print)

Today’s date: Class Date:

PERSONAL INFORMATION

Last name: First: Middle: Mr.

Mrs.

Miss

Ms.

Is this your legal name? If not, what is your legal name? (Former name): Email Address

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Street address: Daytime phone no.: Payment method: Please circle Money order Cashier’s check

P.O. box: City: State: ZIP Code:

Have you ever previously enrolled or inquired at APSTA? Please Circle:

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How did you hear about APSTA?

Family Friend Co-worker Yellow Pages Other COURSE INFORMATION (EACH COURSE HAS A MINIMUM REQUIREMENT OF 10 ATTENDEES)

BCPR104 – CPR and AED - $35.00

BFA105 – First Aid - $35.00

BT101 –Basic Training Course – Eight Hours - Individual - $100.00 Group - $85.00 (minimum of 10 )

BRW102 – Basic Report Writing/Affidavit - $75.00

CDT103 – Courtroom Demeanor/Testifying Course - $75.00

FA301 – Firearms Course – Sixteen Hours - $225.00 - Eight hours classroom - Eight hours fire range

FAR301 – Firearms Recertification Course - $135.00

HBTT201 – Handcuffing and Basic Baton Techniques Training - $45.00

IC105 – Interpersonal Communications - $75.00

LA101- Laws of Arrest Course -

MC202 – Mace Course - $60.00

IN CASE OF EMERGENCY

Name of local friend or relative: Relationship: Home phone no.: Work phone no.: Please make cashier’s check or money order payable to APSTA: Payment can be mailed to P.O. Box 230323, Montgomery, AL 36123. Physical Address: 281 E. Mendel Parkway, Montgomery, AL 36117 Signature Date

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