Kane County Sheriff's Office

Tactical Tracking Class

 

 

Course Date: April 22/25th 2012

 

Course Location: Mt Carmel Junction  UT

 

First Name ______________________Last Name________________________ 

(Please check spelling on name and print or type,  Your certificate will reflect whatever is placed in the name lines)

 

Department______________________________________________________

 

Address_________________________________________________________

 

City  _________________________________  State  __________   Zip

 

Phone Number:  ____________-_________-_________________  

 

Fax:   ___________-__________-__________________

 

Email:   ______________________________________________________________________  

 

 

Emergency Notification Information:

 

Name:    _______________________________________________________________________ 

Relationship:  ___________________________________________________________________    

Address:   ______________________________________________________________________

Phone Number:   _________________________________________________________________

 

Shirt Size   S  M  L XL XXL  XXXL

 

 

Please Fax this form to 435-644-2096

 

Course registration fee is $400.00

 

For orders using a purchase order please contact Kiren Chatterly at 435-644-4316 

 

Registration fees must be received prior to March 15 2012 or your slot will forfeited.

 

NO REFUNDS after March 31st 2012.  

 

 

Please make payment to the Kane County Sheriff’s Office.