Apply for Wait list Enrollment
Servant Leadership
Thursday, February 16 - Friday, February 17, 2023
8:00 am - 5:00 pm
Location: Wake Tech Public Safety Training Center
Directions:
321 Chapanoke Road, Raleigh, NC 27603
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APPLICANT
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required
Enter name as it will appear on certificate
of completion. Do not use all caps.
First Name
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Last Name
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Position/Title/Rank
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AGENCY / ORGANIZATION
Agency/Organization:
If you agency does not appear on the above list
select - Other - above and fill in the
Full Agency Name below:
Other Agency/Organization Name:
Indicate your agency type
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Federal
State
Local
Military
Other (Not Law Enforcement)
AGENCY ADDRESS
Address 1:
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Address 2:
City:
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State:
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Zip code:
CONTACT INFORMATION
(for registration purposes only)
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required
Best Contact Phone # (include area code)
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Cell Phone: (include area code)
E-mail:
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SUPERVISOR INFORMATION
For Law Enforcement Status Verification
Name of Approving Supervisor:
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required
Phone Work: (include area code)
E-mail:
HIDTA TASKFORCE MEMBER
Yes
No
IDENTIFYING INFORMATION
Sworn GA Law Enforcement Officers (for GA POST credit)
Okey #
*
(enter N/A if you are not a Georgia Officer)
Sworn Law Enforcement Officer
Crime / Intelligence Analyst
Other
(please provide details)
Credentials Required at Registration