Start your ONLINE training TODAY

First name *

Middle Initial

Last name *

Company name (optional)

Country / Region *United States (US)

Street address *

Apartment, suite, unit, etc. (optional)

Town / City *

State / County * Select an option…AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)

Postcode / ZIP *

Phone *

Email address *

Last 4 digits of SSN (required by State) *

I herby certify that I am currently 18 years of age or older. *

I hereby certify that the information provided is true and accurate. I also understand that any willful dishonesty is grounds for dismissal and may result in ineligibility for licensure. *

I acknowledge that I have read, understand, and agree to the policies and procedures of Phoenix Security Academy. *

I acknowledge that I have read and understand the disqualifying offenses that cause ineligibility and have determined that I am eligible for the license associated with this course. *