LA HIDTA Training Registration

FOR OFFICIAL LAW ENFORCEMENT USE ONLY
Register to Receive LA HIDTA Training Alerts
Complete the form below.
No partial registrations or personal email addresses accepted.
All registration information will remain strictly confidential

APPLICANT * required
First Name *

Last Name *

Position/Title/Rank *

HIDTA TASKFORCE MEMBER *
Yes No

IDENTIFYING INFORMATION

Sworn Law Enforcement Officer
Crime / Intelligence Analyst
Other
(please provide details)

AGENCY / ORGANIZATION
Agency/Organization Name: *

AGENCY ADDRESS
Address 1:*

Address 2:

City: *

State :*

Zip code:*

CONTACT INFORMATION
(for registration purposes only)
Phone Work: (include area code) *

Mobile Phone: (include area code)

Fax: (include area code)

E-mail: *

Verify E-mail: *

SUPERVISOR INFORMATION
For Law Enforcement Status Verification
Full Name

Phone Work: (include area code)

E-mail:

Credentials always required at event registration