First Strike | Enrollment Form

Participant Information

Name*

First Last

Do you have a nickname?

Date of Birth*

mm/dd/yyyy

Mobile Phone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Participant's Status:*

Please choose the category that best describes you.

Private Citizen
Commissioned LEO
Military
Government Contractor (PMC)
EMS or Medical Field
Private Security
Bailbondsman / Bail Agent
Private Investigator
Other (Please Explain)

Other:

Choose Your Program

Have you participated in a First Strike program before?*

Yes
No

What program did you attend before?

Welcome Back! We love it when our alumni return to attend programs again. Which program did you do with us before, and when?

Choose the Program Group you wish to enroll in today:*

The program group is the broad training area offered by First Strike. Please specify the actual course itself in the notes section.

If other, please explain here or list the specific course you're interested in:

Social Media

Do you use social media?

Yes
No

Facebook Account

facebook.com/username

Instagram Account

@username

Twitter Account

@username

SnapChat Account

@username

Please upload a photograph of your government issued ID:

We have strict limitations prohibiting convicted felons or anyone with a protective order against them from attending our courses. Additionally, in nearly all cases you must be 18 years or older to attend. In order to comply with this policy, we require that you submit proof of your age and identity.

Drop files here or

Max. file size: 512 MB.

Emergency Contact

Emergency Contact*

First Last

Relationship to Student*

Other Family Member / Friend

Please identify your relationship to the emergency contact.

Emergency Phone*

Emergency Email*

Experience & Background

Are you already an Instructor in this or a similar field?*

If you are an Instructor, please share your background in the next section.

Yes
No
I want to become an Instructor

Please share your background and how it relates to this course:*

Please list any relevant certifications and what agencies (LEO, NRA, POST, CLEET, etc.) If none, please write none:*

Please upload a scan or photograph of your most recent certification card (front and back):

Drop files here or

Max. file size: 512 MB.

Are you a member of the NRA?

Yes
No
I'd like to become a member

NRA Number:

Please enter your membership number here.

Program Deposit

A non-refundable deposit is required to enroll in most of First Strike programs. We cannot hold or guarantee space until the deposit is received. Each program has its own deposit amount, so please be sure to choose the correct program. You will not be charged the deposit unless you are accepted into a program.

Deposit Amount:*

Please chose your program deposit amount that matches your in-person course, if required. Details are in the course description.

Deposit Payment Method*

PayPal Address:

Please provide your PayPal address here. An invoice will be generated and sent to you directly.

Type of Credit / Debit Card:

Name on Credit Card

Credit Card Number

Expiration

CVC

Type of Account

Name on Bank Account

Account Number

Routing Number or Swift Code

Help Us Improve Our Reach

Please tell us how you heard about Dive Mentor's programs:

Application Processing

Statements of Understanding*

You must check each section demonstrating you've read it and Agree to the statement.

I understand that if my application is incomplete, I will be denied a place into First Strike's program.
I understand that space is limited, and I am not guaranteed a spot.
I understand that acceptance to some courses are dependent upon passing a criminal background check.
I understand that I should check my spam/promotions boxes in my email to ensure I do not miss any correspondance and I should consider "white listing" info@firststrike and admission@firststrike.com to make sure I get emails regarding this application.

Terms of Service

Certification*

You must check each section demonstrating you've read it and Agree to the statement.

I meet the age requirement listed in the course I wish to enroll in.
I have never been convicted of a violent or drug related felony.
I have never been convicted of a violent or drug related misdemeanor.
I do not now, nor have I ever had a protective order issued against me.
I have never been dishonorably discharged from a branch of the armed forces.
I am not now, nor have I ever been affiliated with a hate group, a terrorist group, or an organization dedicated to overthrowing the US Government.
I hereby certify that all of the details I have provided are true and correct to the best of my knowledge. I understand that if any of my statements provided herein are later to be found false, that I may be removed from the program without being refunded my deposit or fees. I further certify that I have read and agree to the Terms of Service.
I consent to a background check related to this application.

Signature*

I hereby affirm that the forgoing application is true and accurate to the best of my knowledge.

COURSE ENROLLMENT FORM

Participant Information

Choose Your Program

Social Media

Emergency Contact

Experience & Background

Program Deposit

Help Us Improve Our Reach

Application Processing

Terms of Service