DUI/Traffic Safety Course Registration

Your Name Your Name Title First Last Suffix
Agency
Your Email
Your Phone Your Phone - ### - ### ####
I'm signing up for:

I'm signing up for: Myself Another Officer
Officer's Name Officer's Name First Last
Indicate the Officer is:

Indicate the Officer is: Sworn Law Enforcement Non-Sworn (civilian)
Explain current agency position:
Agency
Officer's Email
Officer's Phone Officer's Phone - ### - ### ####
Travel distance from home to training location is:

Travel distance from home to training location is: 50 miles + Under 50 miles

Housing and meals are only provided if you are traveling 50+ miles to the Florida Public Safety Institute.
Which type of course?
Course Location
Course Date Course Date / MM / DD YYYY
Add Another Course?

Add Another Course? Yes No
Course 2 Name and Location
Course Date 2 Course Date 2 / MM / DD YYYY
Questions/Comments