Intoxilyzer 9000 Basic Training - Student Submission Form

PLEASE NOTE:  Upon submitting a registration request, a notification of receipt will appear on your screen.  This notification simply acknowledges that a request has been received and is not a class confirmation notice.  A class confirmation notice will be sent to the contact email once the request has been processed.  This typically takes 5-10 buisness days, but may take longer under some circumstances. 

Additionally,  the number of classes listed as available is dependent upon demand.  Additional classes will be added as the earliest listed classes fill.  Classes may be cancelled if less than 10 registration requests are received. Student will be notified of any cancellations via the contact email provided in the registration request at least 72 hours prior to the start of class.





This is the number assigned to the officer to track POST training credit. It should be a O or C followed by six numbers.  
This should be the agency with whom the student is currently employed.
This is the ORI number assigned to the student's agency.  If it is not known, it may be left blank; however, leaving the agency ORI blanck may slow processing of the registration request. 
Please enter the name of the primary registration contact.  This is the person who will be contacted with all registration communications. It is usually the student or the agency's training officer.
This is the phone number we will use should any need to contact the student regarding changes in class status arises. 
This is the email to which the registration confirmation will be sent.  It is also the primary contact method for all changes in registration status should they occur.
Check this box if you would like the first available class assigned to the student given the requested class is not available.