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First Name:

Last Name:

Company:

Email:

Phone:

Address 1:

Address 2:

City:

State:

Zip:

Comments:

(PLEASE READ)

INFORMATION FORM

If you plan to attend any of our courses or special events, please complete the above information form. Also, tell us how you found us (Google, Craigslist, Word of Mouth, a Friend, Former Graduate, etc.) in the Comments Section.

NOTE: Completing the Information Form aboveDoes Not 

secure your seat for a course - Payment Secures Your Seat. 

Please fill in ALL required information. In the "Comments Section", put the "Course(s)" you are interested in attending, Example: EP Course, PI Course, Security Guard Course, etc. and the date of the course. Also, if a former graduate of this school referred you, add their name as well.

Include your shirt size: SM, M, LG, XL, 2X, 3X, or 4X for academy polo shirt.

YOU WILL BE CONTACTED BY THE PRESIDENT, DR. HOLIFIELD

CHECK YOUR (SPAM) EMAIL - SAVE EMAIL ADDRESS FOR FUTURE EMAILS



Phalanx Training Academy, LLC.

Main: 770-PHA-LANX = 770-742-5269

Toll Free: 1-888-511-5602

Email: phalanxeps@aol.com

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