Self Defense Course Registration - March 2025

Please note that submitting an application does not guarantee admittance into the program.

Part 1
Please fill out the form below and click 'Submit' when complete. Fields marked with an asterisk (*) are required.

Part 2
After submitting Part 1, you will receive an email from University Police with further instructions. Please complete the remaining steps to finish your application.

Select Preferred Training Date

First Name

Last Name

Address Line 1

Address Line 2

City

State/Province

Zip

Cell Phone

Home Phone

Email

Date of Birth

Birth State

Select Correct Title

Emergency Contact Name

Emergency Contact Phone

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Self Defense Course Registration - March 2025