ONLINE ENROLLMENT FORM

Please fill out this simple form to apply for a class. *All information is required and if anything is left out, your application will be withheld from scheduling. Call our office at 815-675-0260 to confirm request and to confirm seating! Please wait 2 days before calling so this form can be processed. (You may also download this form by clicking here and printing out) Bail Enforcement Classes are $425.00 per person.
Please Note: This form is not a Secured Form. If you feel uncomfortable sending this data across the internet without security, please use the printable form and either fax or mail it in.

Please Enter Your Full Name! (As Shown On ID)
Street Address
City, Abbrev. State & Zip Code
Phone Number
Please Enter Your Email Address
Occupation
Dates Chosen
Course & Location
Amount being authorized to charge (per person)
Name on Credit Card
Credit Card Number

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Any info you feel important for us to know.