Please indicate which course you are enrolling in.

First Name
Last Name
Middle Initial
Date of Birth
Social Security #
Drivers License (State/Number)
Home Address
City
State/Province
County
Zip/Postal Code
Home Phone Number
Secondary Phone Number
E-Mail Address
Have you ever served in the United States Armed Forces?		Yes No
If yes, please list dates of service		to
If yes, what branch of the US Armed Forces did you serve?
Students enrolling that are currently employed by a Law Enforcement Agency, please complete section below:
Law Enforcement Agency
Agency Address
City
State/Province
County
Zip/Postal Code
Agency Phone
This statistical information periodically requested from TCLEOSE and the Veterans Administration.  Please check appropriate items.
Gender	Age	Ethnic Background	Highest Level of Education
Male Female	20 Yr. 21-30 Yr. 31-40 Yr. 41-50 Yr. 51-60 Yr. > 61 Yr.	White African American Hispanic Asian Indian Other	High School Diploma or General Education Diploma 12 College Hours 30 College Hours 60 College Hours Associates Degree Bachelors Degree Masters Degree
	In consideration of attending the Basic Peace Officer Licensing course with the Alamo Area Law Enforcement Academy, I am requesting to be permitted to sit for the pre-enrollment exam as indicated above.  I further understand that until the first tuition payment is made my admittance into the academy is not reserved, and should I default on the tuition my position into the class may be forfeited.