Lamar Institute of Technology - Police Officer In-Service Registration Form

Date:

Please select a date.

Course:

Please enter a course name.

PID:

Please enter your PID.

Agency:

Please enter an agency name.

First Name:

Please enter your first name.

Last Name:

Please enter your last name.

Middle Name:

Date of Birth:

Please enter your date of birth.

Sex:

Male

Female

Please select your sex.

Ethnic Origin:

Hispanic or Latino Origin

Not Hispanic or Latino Origin

Decline to Answer

Please select an ethnic origin.

Race Group:

White

Black or African American

Asian

American Indian or Alaskan Native

International

Unknown

Native Hawaiian or Other Pacific Islander

Please select a race group.

Permanent Address:

Please enter your permanent address.

Please enter your city, county, state, and zip.

Home Phone:

Please enter your home phone number.

Cell Phone:

Work Phone:

E-Mail Address:

Please enter a valid email address.

Mailing Address:

Classification (Circle One):

1-Texas Peace Officer

3-Licensed Tele-communicator

4-Elected (not licensed)

5-County Jailer

6-Other (no Texas License)

Please select a classification.

Paid by (Check One):

Cash

Check

Bill Agency

Please select a payment method.

Please Answer (Optional):

Are you academically disadvantaged?

Are you economically disadvantaged?

Do you have disabilities?

Do you have limited English proficiency?

Are you a displaced homemaker?

Are you a single parent?

Have you ever attended Lamar Institute of Technology?

Police Officer In-Service Registration

Course Registration

Regional Police Academy - Certificate