Southern Police Institute Excellence in Policing

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1 Southern Police Institute Excellence in Policing Department of Criminal Justice University of Louisville Louisville, KY Main Office: Fax: SPI Course Inquiry Form To request a training course, please complete Section I (page 1 & 2) only in its entirety. When Section I is completed, the form to Theresa Newton at tmnewt01@louisville.edu SECTION I General Information Course(s) Requested: Course Date/Month Requested: (Please provide a range of dates) Number of participants to be trained from your agency: I am interested in this training course as a: Contract Co-host Contact Information (Individual Requesting Course) Click on "Contract" or "Co-host" to learn more. Agency: Contact address: Would you like to coordinate the course for up to 2 free seats?*(1 seat for course coordination and 1 seat for instructor transportation) Yes No Revised 12/8/2015 *Excludes CODC 1

2 Coordinator Information (If coordinating the requested course, please list name and coordinator s contact information) Agency: Contact address: Training Location/Facility Information Name of Site: Agency/Institute: Address of Facility: Facility Contact Person Seating Capacity of Training Room (maximum): Nearest International/Regional Airport(s) to the Training Facility: Airport Code(s): Distance from Airport to Training Facility (miles & time): Please the form to Theresa Newton when you have completed Section I (page 1 & 2). If you have any questions, please contact Theresa at the Southern Police Institute as listed below. When co-hosting a training course, please keep in mind that a minimum of 6 months is required for SPI to adequately advertise the course. Thank you for your interest in the Southern Police Institute. Theresa Newton, Administrative Assistant Southern Police Institute tmnewt01@louisville.edu Main: (502) Direct: (502) Revised 12/8/2015 2

3 For Administrative Use SECTION II Transportation Arrangements To and From Airport To and From Training Facility To and from Meals Signatory (Who Will Sign Contract/Co-Host Agreement) Information Phone/Extension (Office): Phone (Cell): Address: Training Facility Shipping/Mailing Address (For Course Training Materials) Agency Attn: Mailing Address: Phone Number: Address: Does the Training Facility have daily Ups service? Yes No Recommended Hotel Accommodations For Instructors & Participants (In Order of Priority) Address of Hotel: Mileage from Trng Facility: Contact for Reservations: Revised 12/8/2015 3

4 Hotel Amenities Offered: Address of Hotel: Mileage from Trng Facility: Contact for Reservations: Hotel Amenities Offered: Address of Hotel: Mileage from Trng Facility: Contact for Reservations: Hotel Amenities Offered: Revised 12/8/2015 4

5 Have you previously co-hosted/contracted any SPI courses? Yes No If you answered yes, which courses have you co-hosted or contracted? Title Dates SECTION III Instructor Calendar: Sun. Mon. Tues. Wed. Thurs. Fri. Sat. Contract Sent For Signature Signed Contract Returned Initial Contact With Coordinator Coordinator Packet Sent Instructor Packet Sent Tentative Class Roster Sent To Coordinator Powerpoint Sent To Coordinator Final Class Roster Sent To Coordinator Final Follow-Up With Coordinator Initials Date Revised 12/8/2015 5

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