MORRIS COUNTY PUBLIC SAFETY TRAINING ACADEMY
P.O. BOX 900 MORRISTOWN, NEW JERSEY 07963-0900
(973) 285-2979 - FAX (973) 285-2971

Academy is located at 500 West Hanover Avenue - Parsippany, NJ
POLICE ON-LINE REGISTRATION FORM
* = Required Field

*COURSE TITLE:  
*DATES:     *TUITION:    
*NAME:   AGENCY PHONE:  
  NAME:   AGENCY PHONE:  
  NAME:   AGENCY PHONE:  
  NAME:   AGENCY PHONE:  
  NAME:   AGENCY PHONE:  
  NAME:   AGENCY PHONE:  

Separate forms are required for each course.

CERTIFICATIONS: I hereby certify the above listed personnel are covered by Workmen's Compensation and Liability Insurance or otherwise adequately insured. The Academy requires a certificate of insurance from every sending department. Certificates are to updated yearly. Certificates of Insurance requested by the County of Morris must contain the following language: "THE COUNTY OF MORRIS IS AN ADDITIONAL INSURED."

To the fullest extent permitted by law, the municipality, or agency requesting training for this individual, agrees to defend, indemnify and hold harmless the County of Morris, the Morris County Public Safety Training Academy, and all employees, servants and agents ("the County") from any liability, claims, civil actions, and expenses (including reasonable attorneys' fees) arising out of the training or instruction to be provided at the Academy. Said agreement shall apply, regardless of the allegations made against the County by the officer, this organization, or a third party.

NOTE: All classes will begin at 8:30 am unless otherwise noted in the training catalog

*CHIEF NAME: 
*DEPARTMENT: *PHONE:
*ADDRESS:   FAX No:
*TOWN/ST/ZIP:   E-MAIL:
*SIGNATURE OF CHIEF OR AUTHORIZED OFFICIAL:
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