IDC/Facilitator Development Course Registration Application
Complete & electronically sign form

For more information on the Center for Policing Excellence, please visit our website at: http://www.oregon.gov/DPSST/CPE/pages/index.aspx

Course Title & Location *
Your answer
Course Date(s) *
Your answer
DPSST # (required for certified personnel)
Your answer
Rank/Title *
Your answer
Discipline *
Your answer
Student Name *
Your answer
Work Email (notice of confirmation will be sent to this address) *
Your answer
Employing Agency *
Your answer
Agency Mailing Address *
Your answer
Office Phone (w/extension) *
Your answer
Work Cell Phone
Your answer
Supervisor's signature authorizing participation IS REQUIRED
By (electronically) signing below, I affirm that the applicant(s) listed on this registration application and any attached sheet(s) is/are approved by me to attend the training listed above.
Supervisor's Electronic Signature (print full name) *
Your answer
Supervisor's Rank/Title *
Your answer
Date *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Department of Public Safety Standards and Training. Report Abuse - Terms of Service - Additional Terms