31.12.2012 Views

New Course! - North East Multi-Regional Training, Inc.

New Course! - North East Multi-Regional Training, Inc.

New Course! - North East Multi-Regional Training, Inc.

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

NORTH EAST MULTI-REGIONAL TRAINING<br />

355 Smoke Tree Plaza<br />

<strong>North</strong> Aurora, Illinois 60542<br />

Tel: (630) 896-8860<br />

Registration: Ext. 112<br />

Fax: (630) 896-4422<br />

Consent for Participation in<br />

4 Hour/40 Hour Mandatory Firearms <strong>Training</strong><br />

(please circle that which applies)<br />

Please fax the completed consent form and a copy of FORM E to NEMRT with the course pre-registration<br />

form. If you have any questions concerning this waiver, please call Ms. Melinda Ray, Registrar, at (630)<br />

896-8860, ext. 112, or contact her via e-mail to Melinda@nemrt.com.<br />

Participant's Name:<br />

Date of Appointment:<br />

Employment Status (choose one):<br />

Full-Time<br />

Part-Time<br />

Auxiliary<br />

-Has a copy of this officer's Form E Card been included with this waiver?<br />

-Has the original Form E Card been forwarded to the Illinois Law Enforcement <strong>Training</strong> Standards Board?<br />

I agree that my agency and the personnel I am sending to this 4 Hour or 40 Hour Mandatory Firearms<br />

<strong>Training</strong> Program will abide by the regulations and procedures set forth by the Illinois Law Enforcement<br />

<strong>Training</strong> Standards Board and <strong>North</strong> <strong>East</strong> <strong>Multi</strong>-<strong>Regional</strong> <strong>Training</strong>.<br />

I also agree that the personnel I am sending to this 4 Hour or 40 Hour Mandatory Firearms <strong>Training</strong><br />

Program will be participating as part of their official assigned duties.<br />

<strong>Course</strong> Dates:<br />

Assigning Agency:<br />

Signature of Chief:<br />

Please Note: This information must be completed and returned to NEMRT offices prior to the first day of class.<br />

Winter 2011-12 In-Service <strong>Course</strong> Catalog 121

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!