Field Training Officer Master Trainer
Registration Form


1 person $695.00
2 or more persons $670.00 per each person
Make checks payable to APTAC
Payment must be received 2 weeks prior to class start date


         Location:                 St. Louis County & Municipal Police Academy
1266 Sutter Avenue
                  St. Louis, Missouri  63133-1934

                  Contact – Becky Murphy – 314-889-8608 – bamurphy@stlouisco.com
                  www.stlcmpa.org

Date:                November 10 – 21, 2008

Student Information

1. NAME: _______________________________  RANK: ______  SSN: _____-____-______


2. NAME: _______________________________  RANK: ______  SSN: _____-____-______


3 NAME: _______________________________  RANK: ______  SSN: _____-____-______


Authorized Training Registrar: __________________________________________
(must sign here)

Print or type Registrar's Name: __________________________________________

Title: __________________________________________

Department Information

Department:         ____________________________________________________

Address:                ____________________________________________________

                       ____________________________________________________

Phone #:                ____________________________________________________


FAX #:                ____________________________________________________