STUDENT INFORMATION * required
First Name *

Last Name *

Position/Title/Rank *

Phone Work: (include area code) *

Cell Phone: (include area code)

E-mail: *


HIDTA TASKFORCE MEMBER
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IDENTIFYING INFORMATION
Sworn Law Enforcement Officer
Crime / Intelligence Analyst 
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AGENCY / ORGANIZATION  *
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Address: *

City: *

County: *

SUPERVISOR INFORMATION
For Law Enforcement Status Verification
Full Name

Position/Title/Rank

Phone Work: (include area code)

E-mail:

 Credentials are required at event. Questions: info@lahidtatraining.org