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Training Application
Training Application
Please be sure to fill out a complete application for each person you’ve purchased a course for
Step
1
of
6
- Student Information
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Name
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First
Last
LEA Agency/Military Unit (if applicable)
Rank
Address
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Street Address
Address Line 2
City
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State
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Country of Birth
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Country of Birth
Afghanistan
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Angola
Anguilla
Antarctica
Antigua and Barbuda
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Armenia
Aruba
Australia
Austria
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Chile
China
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Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
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Côte d'Ivoire
Denmark
Djibouti
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Dominican Republic
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El Salvador
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Eritrea
Estonia
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Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
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Greenland
Grenada
Guadeloupe
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Guatemala
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Guinea
Guinea-Bissau
Guyana
Haiti
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Holy See
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India
Indonesia
Iran
Iraq
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Panama
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Poland
Portugal
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Virgin Islands, U.S.
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Email
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Emergency Contact
Emergency Contact Person
First
Last
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Contact Phone
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Which Course are you taking
Advanced PSD Operations Specialist
Bodyguard Executive Protection Certification
Predator Defender – Two-Day High Threat Operations
Predator Guardian – Three-Day High Threat Operations
PTUCS Unarmed Combatives Certified Instructor
PTUCS Special Operator One (Military Only)
The Program
The Game
Date of the Course
MM slash DD slash YYYY
Years of training (please explain)
(Required)
Pistol Training
(Required)
Carbine Training
(Required)
Please provide a brief Bio on any prior tactical, military, law enforcement and hand to hand training
Draw
(Required)
Draw
Left Hand Draw
Right Hand Draw
T-Shirt size
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UntitledChest
(Required)
Waist
(Required)
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driver’s license, military photo ID, government ID card
A copy of unexpired passport
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Copy of DOD Form DD214
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If prior service
This is your medical history form, to be completed prior to acceptance. All information will be kept confidential. This information will be used for the evaluation of your health and readiness to begin training. The form is extensive; please try to make it as accurate and complete as possible. Please take your time and complete it carefully and thoroughly, and then review it to be certain you have not left anything out. The answers given here as well as other factors, will help us determine if you are cleared as a candite. If you have questions or concerns, if you have a significant cardiac or musculoskeletal injury history you may want to have a formal medical clearance exam by your medical provider prior to the course as a medical clearance.
Family Physician and/or Primary Health Care Provider:
Doctor/Other
Phone
Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Occupation:
Position
Employer
Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Employer Phone
Present Medical History
Check those questions to which you answer yes (leave the others blank).
Have you had a heart attack or cardiac bypass surgery/procedure?
Are you on blood pressure or anticoagulant medications?
Do you ever have pain in your chest or heart?
Are you often bothered by a thumping or irregular beat of the heart?
Has a doctor ever said that you have or have had heart trouble, an abnormal electrocardiogram (ECG or EKG), heart attack or coronary?
Do you often have difficulty breathing?
Do you get out of breath long before anyone else?
Chronic, recurrent or morning cough, or respiratory disease?
Increased anxiety or depression? Nervous or emotional problems or PTSD?
Migraine or recurrent headaches?
Swollen or painful knees or ankles, stiff or painful joints or arthritis?
Back problems?
Significant vision or hearing problems?
Injuries to back, arms, legs or joints?
Any problem that prevents participation in athletics, combatives, hot or cold weather physical performance in an austere setting?
Diabetes or abnormal blood-sugar tests
Dizziness or fainting spells
Epilepsy or seizures
Comments
Prescription medications/supplements
List any drug allergies
Media Consent
(Required)
Media Consent
Yes
No
Do you allow TSG to use images or videos of you captured during your courses for promotional use?
Contact Release
(Required)
Media Consent
Yes
No
Do you allow TSG to pass on your contact information to partners?
Background Check
(Required)
I authorize TSG permission to run background Investigation.
Physically Fit
(Required)
I certify that I am physically able to attend tactical training.
SERE Agreement
(Required)
I acknowledge that this is an operator level course and will undergo TSG's SERE and other mental and physical demanding training iterations that are a required part of our top tier tactical training pipelines.
How did you find out about Tactical Solutions Group
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