Street Racing/Sideshow and Modified Vehicle Enforcement Training
Thursday, May 9, 2024
8:00 AM - 5:00 PM
Location: Mariners Church
Directions: 5001 Newport Coast Dr, Irvine, CA 92603

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50 Class Limit

STUDENT INFORMATION  *  Required
First Name: *

Last Name: *

Middle Name:
 
Position/Title/Rank:*

YOUR AGENCY/ORGANIZATION NAME: *
Work Address*
 
Address 2
 
City:*

State:* (2 characters)

Zip Code:*

CONTACT INFORMATION
Work Phone: (include area code)*

Cell Phone: (include area code)
 
 Email Address:*
 
Law Enforcement Agency Email Address Required
IDENTIFYING INFORMATION*
Post ID#:   

Date of Birth:*
 
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: *
From:

To:
 

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*
Law Enforcement Credentials Are Required at Registration