2. First Name*

3. Last Name*

5. Email Address*

6. Phone Number*

8. Participant is the same as above

   1. Yes
10. Participant First Name

11. Participant Last Name

13. Participant Phone Number*

14. To ensure eligilbility*
    -- Select One --Full Time Law EnforcementHonorably Retired Peace OfficerCivilian Support StaffOut of State OfficerA State of Texas Licensee

16. Payment Info

    Credit Card

17. Price

18. Quantity*

19. Shipping Cost

21. Taxable

23. TCOLE PID #*

25. Participant Email Address*

27. Agency Name*

29. Agency Address*

Leave This Blank:


30. Calculate Totals Proceed to Checkout

* indicates a required field