ICISF Assisting Individuals in Crisis

*COVID-19 Disclaimer*
The safety and wellbeing of the training participants, instructors, venue staff and DCJS staff are of the utmost importance during the current pandemic, therefore DCJS will be implementing a number of safety protocols for all DCJS hosted events.

Failure to comply with any these guidelines will result in a removal from the training, premises and agency notification. The Division reserves the right to follow up with any attendee or agency in the event of a failure to notify DCJS staff of trainee absence, likewise, attendees must notify DCJS staff of any absence after the commencement of training. Trainees must also notify DCJS staff of an exposure to COVID-19 within 14 days after culmination of training.

Completion of this registration DOES NOT guarantee you a seat in the class. Confirmation notices will be e-mailed approximately 2 weeks prior to the class. Those who do not register will not receive this important notification and will not be admitted to the training. Walk-ins and transferring of confirmation notices will not be permitted. Please remember to check your junk/spam folder.

**Contact information provided will be used in the event contact tracing is required**

If you have any questions please contact Scott Neff at Scott.Neff@dcjs.ny.gov

*Pursuant to NYS Personal Privacy Protection Law, DCJS is authorized to collect personal identifying information as part of a public safety agency record. Personal identifying information on this form shall not be revealed, released, transferred, disseminated or otherwise communicated orally, in writing, or by electronic means other than to the registrant. Disclosure of personal identifying information is voluntary. Refusal to provide personal identifying information shall not result in the denial of any right, benefit or privilege.

2. Attendee *This question is required.

Title/Rank

Last Name *This question is required.

First Name *This question is required.

Birthdate (Please enter as MM/DD/YYYY) *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Person ID: (Please enter in the following format - Last Name-DOB-Last 4 of SSN)
Example: Smith-01011999-1234 *This question is required.

Agency Name
Please begin typing agency name for ease of navigation of the list below. If your agency is not listed, please scroll to the bottom of the list and select "Agency Not Listed" and enter agency name and address in the fields that will appear below. *This question is required.

Agency Name and Address if not listed above *This question is required.

Agency Street Address *This question is required.

Address 2

City *This question is required.

State *This question is required.

Zip *This question is required.

Attendee E-mail Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.

Position *This question is required.

If you are a peace officer, please indicate the type (i.e. Probation, Corrections, Parole, etc):

If you are a civilian, please indicate your job title or relationship to the material (i.e. Investigator, Forensic Accountant, etc):

Employment Status *This question is required.

3. Supervisory Approval *This question is required.

First Name

Last Name

Title

E-mail Address

4. Attendance Confirmation (E-Mail address) *This question is required. This question requires a valid email address.

Training Certificates
Certificates of completion for any DCJS hosted training event will be available for download for any police or peace officer listed on the NYS Police/Peace Officer Registry through the DCJS Acadis Portal. Please contact your agency Acadis Point of Contact to access and download your certificate.

Civilian attendees may request a copy of their certificate by contacting DCJS at email listed below.

Any questions or assistance regarding obtaining a DCJS hosted course certificate may be directed to ops.generalpolicing@dcjs.ny.gov.

Please contact Bert Bouchey at bert.bouchey@dcjs.ny.gov email for questions or concerns.