Surveillance Course Application
Form (BLOCK CAPITALS)
Please complete and print the form
below:
Full Name:........................................................................................................
Date of Birth:....................................................................................................
Address:..........................................................................................................
.........................................................................................................................
Telephone: (work/home/mobile) .....................................................................
E-mail: ............................................................................................................
Please give any details of any security
experience: (If none write none)
........................................................................................................................
.........................................................................................................................
Have you any specialist knowledge
or training? ....................... .....................
.........................................................................................................................
.........................................................................................................................
Present employment: .....................................................................................
Driving licence: Yes ..................
No ...........................
Declaration - I am over 18 years
of age and in good health.
Signed: ............................................................................................................
Which month would you prefer your course? ................................................
Please give second choice: ...........................................................................
Declaration - I understand that
the PBA are under no liability for the loss of any personal
possessions nor accidents due to my own negligence which happen
when attending the Training Course.
Signed: ...........................................................................................................
Free accommodation required the
night prior to the course:
YES ............. NO ..................
Please print and return
to PBA, P.O. BOX 532, Durham, DH1 9DW.
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