Author: Kelly Amador

SOUTHEASTERN NEW MEXICO LAW ENFORCEMENT ACADEMY
#1 Thunderbird Circle
Hobbs, NM 88240
www.nmjc.edu/dps
CERTIFICATION BY WAIVER (CBW) CLASS #23
Registration Form

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COST:
Course Fee: $600.00 per officer
*Course maximum is 20 officers
Lodging: $25.00 per night
*If dorms are available we will inform agencies closer to CBW class date
Please circle if lodging is needed: Yes No
Please specify one of the following: M F

Full Name: ___________________________________________ NMDPS Certification /SS#: __________________________
Mailing Address: ______________________________________ City: _______________ State: _____ Zip: _____________
Telephone: (________)__________________________________ E-Mail Address:__________________________________
Agency___________________________________________________________________________________________________
Mailing Address:_______________________________________ City: _______________ State: _____ Zip: _____________
Contact Person: ________________________________________ Telephone: (_________) ___________________________
E-Mail Address:____________________________________________________________________________________________
Payment Methods: Credit Card, Check or Money Order made payable to New Mexico Junior College/SNMLEA
Invoice PO # _____________________________
Credit Card: Visa Mastercard
Card #: ________________________________________________
Expiration Date: __________ /__________ CCV # _________
Print Cardholder Name: _______________________________________________
Signature: __________________________________________________________
Billing Address: ______________________________________________________
City: __________________________ State: _______ Zip:______________
Completed packets must be received in our office no later than June 8, 2020
A COMPLETE application package MUST be received and reviewed by the SNMLEA Lead Instructor, Antonio De La Fuente on or before June 8, 2020. If an application package has not been received to the Lead Instructor and determined to be COMPLETE on/by the deadline, the applicant will be scheduled for the next available CBW training class.
Cadets dorms are not required but are available at $25.00 per night if interested.
During Class hours please wear uniform or business casual. No Jeans!

Please mail or email completed
registration form with payment to:
New Mexico Junior College / SNMLEA
Division of Public Safety Programs
Attention: Lupe Madrid
#1 Thunderbird Circle
Bob & Bonnie Moran Hall
Hobbs, NM 88240
(575) 492-2720
lmadrid@nmjc.edu
Fax: (575) 492-2712

For more information, please contact Antonio De La Fuente at (575) 492-2715, adelafuente@nmjc.edu or Lupe Madrid,
Administrative Assistant at (575) 492-2720, lmadrid@nmjc.edu

DATES:
July 13-24, 2020
TIME:
08:00 hours—17:00 hours, M-F
LOCATION:
NMJC, Bob & Bonnie Moran Hall, Room 146