Columbus Division of Police
Regional Training Center

Columbus Police Academy
1000 North Hague Avenue
Columbus, Ohio  43204

Phone: (614) 645-5028 Fax: (614) 645-5029


Please submit one form for each student and each course.
At this time registration is only accepted via the use of this form.
Student Contact Information:
Last Name:   
First Name:  
Middle Name:  
Rank:  
Gender:         
DOB:     
Daytime Phone:  
Agency:   
Street Address:  
City:     
State:  
Zip Code:         
Agency Telephone Number:
Agency Fax Number:   
Student's email address:

Course/Reservation Information
:
Course Title:
Course Date(s):
Total Cost:
**Registered enrollees who do not attend and did not cancel the registration two working days prior to the course will be charged an administrative fee equal to one-half the total course fee.
How did you hear about this course?






If you answered "Trade Show," which one?
   
Billing Information:
Billing Contact:
Title:
Billing Address:   
City: 
State: 
Zip Code: