Registration Form for LPT Courses

Paid for by: Hit Arrow: *

Last Name (Add Jr. Sr. etc if appropriate) *

First Name *

Middle Name

Last 4 numbers of SS No dashes (Needed for DPS Certificate) * 🛈

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Emergency Contact Name: *

Emergency Contact's Phone #: *

Which class are registering for: *

Level 2 Non-Commissioned Security Officer

Level 3 Commissioned Security Officer

Renewal for Level 3 Commission

Level 4 Personal Protection Officer

LTC (License to Carry) Not for Private Security

Firearms Safety Class (ONLY)

Certified Process Server

CE for Company Representative, Private Investigator, Alarm Installer

I understand and agree to the following: *

	You must agree to the following:
I understand that if I do not complete this course that I will not receive a refund.	You must agree to the following:
I understand that I do not have any disqualifying offenses and if that is discovered at a later time that I am totally responsible.	You must agree to the following:
I hold harmless Loss Prevention Texas from any and all liability.	You must agree to the following:

What is the first day of the class for which you are registering. Verify date on https://lptips.com website before entering. * +

I understand that by signing this form, I have checked and understand that all fees paid for training are not refundable and that I agree to all Hold Harmless and other agreements set forth by Loss Prevention Texas, its owners, instructors, staff and facilities used. *

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