REGISTRATION

REGISTRATION

(PLEASE READ)
COURSE REGISTRATION FORM

If you plan to attend any of our courses or special events, please complete the registration form, and tell us how you found us (Google, Craigslist, Word of Mouth, a Friend, Former Graduate, etc.) in the Comments section. A Phalanx representative will contact you within 24 hours.

NOTE: Completing the registration form (Does Not) secure your seat for a course – Payment Secures Your Seat. Please fill in ALL required information (NO P.O BOX ADDRESS, Physical Address Only) In the “Comments Section”, include the “Course(s)” you are interested in attending, Example: 10 Day Executive Protection Course, Private Detective Course. Security Guard Course, etc. your shirt size, plus the Date of the course. Also, let us know how you heard about us (Craigslist, Facebook, Internet, Word of Mouth). If a former graduate of this school referred you, add their name as well.

Include your shirt size: SM, M, LG, XL, 2X, 3X, or 4X for academy polo shirt.

For additional information call or email us at:

Phalanx Training Academy, LLC.

Office: 770-799-6471
Fax: 770-917-9218
Email: phalanxeps@aol.com





















Are you a U.S. Citizen? YesNo


Have you ever served in the military? YesNo




Have you ever held a Law Enforcement Commission? YesNo
Are you now, or have you ever been licensed or registered as a private security officer or a private detective? YesNo

Is your license current, expired or N/A? CurrentExpiredN/A
Do you hold a CCW license? YesNo
If so, is it current, expired or N/A? CurrentExpiredN/A
Are you a certified Firearms Instructor? YesNo
If so, under what school or organization are you certified to each?
If yes, what firearms are you certified to teach?
What would you rate your current fitness level? ExcellentGoodFairPoor
Have you ever attended Executive Protection Training before? YesNo
If so, what school did you attend and what year did you graduate?
Do you have martial art training? YesNo
If so, what style and how many years?

Have you ever been convicted of a Misdemeanor or Felony? YesNo
If so, which one and what was the charge and disposition?
Is there currently any charge pending against you for a criminal offense? YesNo
Are you under indictment or information in any court for a felony, or any other crime, for which a judge could imprison you for more than one year? YesNo
Are you a fugitive from justice? YesNo
Have you ever been disciplined or cited for a breach of ethics or unprofessional conduct? YesNo
Have you ever been reprimanded, placed on probation, or otherwise disciplined by a professional licensing or certification body? YesNo
Have you ever resigned or been discharged from any position with criminal or administrative charges pending against you? YesNo
Are you a fugitive from justice? YesNo
Are you an Alien illegally in the United States? YesNo
Have you ever renounced your United States citizenship? YesNo