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format: Professional Development Registration Request Form pdf format of Professional_Development_Registration_Request.pdf
 

An application is provided that may be printed. It is recommended that departments photocopy this form for distribution. All applications must be properly filled out and include the signature of a supervising officer or departmental training officer. Uniformed Massachusetts State Police personnel will submit all training requests through Troop Executive Officers for approval. State Police personnel assigned to investigative positions will submit training requests through D.I.S. Headquarters for approval. The Professional Development Coordinator requires early registration to facilitate program planning.

RESERVATIONS: All interested personnel are requested to submit and application form to Trooper Dana Lavigne at Fax # (508) 867-1100.  Trooper Lavigne can be reached at (508) 867-1121 to confirm availability of space in each class PRIOR to faxing or mailing any registrations forms.  Only those applications verified by phone will be accepted. Any questions pertaining to curriculum / course content can be directed to the Professional Development Coordinator at (508) 867-1000.

CANCELLATIONS AND REPLACEMENTS: Applications are accepted in relation to course capacity set by the instructor. It is necessary to limit the number of applicants in some instances due to technical specifications in training. When courses are fully subscribed, applicants will be placed on a waiting list. Anyone unable to attend a training class is requested to call and give a 24 hour notice of cancellation to accommodate those awaiting an opening. Failure to comply will result in ineligibility to register for future training.

CLASS STARTING TIMES: All specialized training courses are scheduled to begin at 0900 hours daily unless specifically noted.

ENROLLMENT ELIGIBILITY: All law enforcement officers are eligible for scheduled courses unless otherwise specified.

FACILITY ARRANGEMENTS: The Massachusetts State Police Academy will provide overnight accommodations, free of charge, for anyone attending a specialized training class. All personnel are asked to indicate on the registration form if accommodations are required. There are no tuition costs to the applicant. A minimal charge will be incurred for all meals provided.  Departments are asked to make photocopies of the application for distribution among personnel.




MASSACHUSETTS STATE POLICE ACADEMY
PROFESSIONAL DEVELOPMENT REGISTRATION REQUEST

Fax Registration Request to:

Professional Development Coordinator
Massachusetts State Police Academy
340 West Brookfield Road
New Braintree, MA 01531
Telephone: (508) 867-1000 / FAX: (508) 867-1100
Telephone Registration/Verification/Cancellation: Call Trooper Dana Lavigne at (508) 867-1121

COURSE INFORMATION
Course Title:Course Date(s):
STUDENT INFORMATION
Rank:Last Name:First Name:MI:
ID No.:DOB:Social Security No.:
Department/Agency:
Mailing Address:
City/State/Zip:
Telephone:FAX:
Are overnight accommodations needed? YES NO

ACKNOWLEDGMENT
I hereby acknowledge that I have read the rules and regulations on page 7 for attending specialized training classes at the Massachusetts State Police Academy. I understand that any infractions may result in my dismissal from this training session, notification to my department and prohibit me from attending future training sessions.
Student Signature:Date:
AUTHORIZATION
Name of Authorizing Official (Print):Title:
Signature of Authorizing Official:Date: