INCOSIT Registration Form

First Name:
Middle Initial:
Last Name:
Preferred Name:
DOB:
PID Number:
Ehnicity:
Gender:
Education Level:
Rank:
Department:
Mailing Address :
City:
State:
Zip:
Work Phone
Fax:
E-mail:
Register me for
Class:
Date of Training:

Note: Non-Law Enforcement Applicants should contact INCOSIT for payment options. You can call 936-2944698 or 936-2943327. You may send your e-mails to magdalena@shsu.edu or manousos@shsu.edu.