Drug Endangered Children (DEC)
Wednesday, May 10, 2017
8:00 AM - 5:00 PM
Location: DOJ-Fresno Regional Office
Directions: 1735 E Street Fresno, CA 93706

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Class limited to 100

STUDENT INFORMATION  *  Required 
First Name: * 

Last Name: * 

Middle Name:
 

Position/Title/Rank:*

YOUR AGENCY / ORGANIZATION NAME

Work Address*

 
Address 2
 
City:*                                                                                                                                                                                                                               

State:*

Zip Code:*

     

CONTACT INFORMATION
Work Phone: (include area code)*

Contact Phone: (include area code)*

Cell Phone: (include area code)
 
 
E-mail:*
 
(Please Use Law Enforcement Agency Email Address)

IDENTIFYING INFORMATION*
(Please provide your POST # if you would like POST Credit) 
Post ID#  

Date of Birth (mm/dd/yy):*
 
Gender* Male Female

Previous Last Name (enter N/A if the same):



HIGH SCHOOL LAST ATTENDED*

Name of High School*
 
County*
 
State (or Country if outside U.S.)*
 
Years Attended*
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Year Graduated*
 

High School Graduation Status*
 

WHEN DID YOUR PRESENT STAY IN CALIFORNIA BEGIN?*

Approximate date you arrived in California? Enter birth date if always in CA (mm/dd/yy)*


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