Student Profile | SECFOR360

Name *

First

Last

Nickname

Email *

Email

Confirm Email

Mobile Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Name of Organization/Company/Sponsor if relevant

What course are you attending? *

Please select 4 Day EP Immersion course dates *

Executive Protection Certificate Course *

Please select 8 Day Hard-Skills course dates *

Please list what course you are attending

Date of Birth (M/D/Y) *

Emergency Contact *

First

Last

Relationship to you *

Emergency Contact Phone *

How did you hear about the course? *

If "Other" Please Explain:

If you have any medical conditions please list below:

If taking any medications please list below:

T- Shirt Size *

Firearms Preferred *

Glock
Smith & Wesson M & P
Bringing my own handgun

Holster *

Right Hand
Left Hand

Do you have WhatsApp installed in your phone? *

Yes
No

If no, can you please download Whatsapp before attending the course? We use Whatsapp to communicate with all students. We will create a group which will include the students and instructors involved with this course only. Please download WhatsApp to your smartphone

Authorization to add you to your course WhatsApp chat group *

Yes
No

Roughly 24 hours before the course begins, we will create a group which will include the students and instructors involved with this course only. Please download WhatsApp to your smartphone

Executive Protection & Work Experience

Let us know what prior relevant work experience you have, if any

Please let us know the extent of your prior experience. Corporate, Government, Military PSD, or other security experience, and how much time on the job you have.

Current Position

Briefly explain non-classified details regarding your current employment

Medical Licensing & Language Capabilities

Medical Licensing and/or Certification

If "Other" or previously certified list and/or explain here:

Language Capability (Working Proficiency)

Other Language(s):

Relevant Training

Protection/Driving/Medical Course 1

Let us know where you have trained

What primary subjects were taught

Evasive driving, Firearms, Medical, Surveillance, TSMC, Immediate actions, etc

Protection/Driving/Medical Course 2

Let us know where else you have trained

What primary subjects were taught

Evasive driving, Firearms, Medical, Surveillance, TSMC, Immediate actions, etc

Additional Relevant Training

What other training have you attended?

What primary subjects were taught?

Evasive driving, Firearms, Medical, Surveillance, TSMC, Immediate actions, etc

Military Service

Military Branch?

If "Other" please explain here?

Status

Active
Reserve
Veteran
Retired

Years of service

Expectations

What do you hope to get out of the upcoming training?

Let us know what you are looking forward to during the upcoming training

What, if any, concerns do you have regarding the upcoming training?

Is there anything that you are NOT looking forward to or concerned with regarding the upcoming training

Other Courses/Subjects you are interested in