Asset Forfeiture
Wednesday, July 19, 2017
8:00 AM - 5:00 PM
Location: Gaia Hotel & Spa
Directions: 4125 Riverside Place Anderson, CA 96007

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Class Limit 60


STUDENT INFORMATION * Required
First Name:*
Last Name:* 
Middle Name:  
Position/Title/Rank:* 

YOUR AGENCY / ORGANIZATION NAME*

Work Address*  

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*
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*  -  
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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      Law Enforcement Credentials Are Required at Registration