/ Southwest Va. Criminal Justice Academy
ONLINE TRAINING ENROLLMENT FORM
NOTE: THIS IS A TWO PAGE FORM

STUDENT INFORMATION: PAGE 1

SESSION DATES:October 1 - December15, 2012Last four ssn______

Name: Department:

Please place an “X” on the line next to the course (s) you would like to have a student enrolled.

New or recently revised courses have been placed in bold and italics

OPTIONS FOR LEGAL HOURS:

2010 Virginia Statute & Case Law Legal Update (4 hrs.)___

2011 Legal Update _____

2011 Virginia Case Law Legal Update (4 hrs.) ___

2011 United States Case Law Update (4 hrs.) _____

2012 Virginia Legal Update ______

Arizona v. Gant 2009 (1 hr.) ___

Legal Update (Case Law) for Jailors (4 hrs.) ___

OPTIONS FOR CULTURAL DIVERSITY HOURS:

Cultural Diversity Online revised 1-2011 (2 hrs.) ___

Racial Profiling (3 hrs.) ___

INSTRUCTOR RE-CERTIFICATIONS: (you must enroll in General if you enroll in a Specialty and you wish to have your General Instructor Status Re-certified)

Defensive Driving Instructor Re-Cert Online New for 2011(2 hrs.) ___

Firearms Instructor Re-Cert Online New for 2011(2 hrs.) ___

General Instructor Re-Cert Online New for 2011(2 hrs.) ___

Speed Measurement Instructor Re-Cert Online New for 2011(2 hrs.) ___

STUDENT INFORMATION: PAGE 2SESSION DATES:October 1 - December 15, 2012

Name: Department:

OPTIONS FOR CAREER DEVELOPMENT HOURS:

Alzheimer’s Disease (6 hrs.) ___ Gang Training (8 hrs.)___

Alzheimer’s Disease for Jail Staff (6 hrs.) ___ Identity Theft (4 hrs.) ___

Autism: Recognition and Response (2 hrs.) ___Inmate Con Games (3 hrs.) ___

Blood Borne Pathogens for Jail (2 hrs.) ___ Interviews and Interrogations (7 hrs.) ___

Blood Borne Pathogens for LE (2 hrs.) ___Line of Duty Death Benefits (0 hrs.) ___

(As a courtesy to our online agencies)

Bomb Threat Response (4 hrs.) ___Managing Mentally Ill Inmates (5 hrs.) ___

Cell Extractions, Safety, and Searches (4 hrs.) ___Managing the Older Offender (4 hrs.) ___

Community Policing (2 hrs.) ______NIMS/ICS Refresher (2 hrs.) ___

Consular and Diplomatic Immunity (7 hrs.) ___Officers and Online Social Networking ___ (2 hrs)

Counter Terrorism CBRNE (4 hrs.) ___Prison Rape Elimination Act (2 hrs.) ____

Counter Terrorism General Issues (8 hrs.) ___Search and Seizure (8 hrs.) ___

Counter Terrorism Prevent and Deter (3 hrs.) ___Serving Warrants (5 hrs.)___

Courtroom Security (4 hrs.) ____ Sovereign Citizen (6 hrs.) ____

Cross-Gender Supervision of Inmates (4 hrs.) ___Suicide Prevention in Jails (8 hrs.) ___

Dealing with Inmate Behavior (4 hrs.) ___Use of Force (8 hrs.) ___

Domestic Terrorism and Hate Groups (9 hrs.) ___Visual Tracking in LE (6 hrs.) ___

Drug Recognition Refresher (10 hrs.) ___Witness Intimidation (6 hrs.) ___

Please return both pages of this form to:Southwest Virginia Criminal Justice Academy

FAX to: (276) 645-3719 or

E-mail:

Form completed by (Please print): ______

Telephone Number:______Agency Email address:______