On-Line Registration
 
SECURCORP Inc. Training Center
1529 Old Bridge Road, Suite 102
Woodbridge, VA 22192
703-499-9359
703-499-9389 (Fax)
www.securcorp.com
DCJS School 88-1495
 
You may register and pre-pay for classes using our convenient on-line registration form or print the form and fax it to the number listed above.
 
Name:
Address:
 
City:
State:
Zip:
Phone:
Cell Phone
Email
Please register me for the following courses:
Course: Cost: Date:  
Course: Cost: Date:  
Course: Cost: Date:  
List any previous training:
 
If registering for the Firearm Endorsement Class list the make and model of the firearm you will use for the training:
Make: Model:
Do you want to purchase ammunition from us? Yes No
Due to limited class sizes, pre-payment is required to reserve a seat for training classes.
Pay on line using our secure on-line payment through PayPal.
Print the form, sign and fax or mail to SECURCORP
A check or money order made out to SECURCORP, Inc. may also be included with the registration form for pre-payment orders only. No checks will be accepted the day of the training.
   

 
   
 
 
 
     
 
CORPORATE OFFICES | 1529 OLD BRIDGE ROAD | SUITE 102 | WOODBRIDGE, VA 22192 | 800-711-8118
VA LICENSE NO. 11-1595 / VA DCJS School ID # 88-1495
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