40941_1/16 Campus Public Safety Officer Training Academy Registration Form Please note that space is limited and filled on a first- come, first-served basis. Please complete the form in its entirety and return as soon as possible to: Fairfield University Department of Public Safety 1073 North Benson Road Fairfield, CT 06824-5195 Please print clearly Name ______________________________________________________ (as it will appear on your certificate) q Male q Female College or University _______________________________________ Department ________________________________________________ Position ___________________________________________________ Years of Experience _________________________________________ Work Address _____________________________________________ Town or City _______________________________________________ State ______________________ Zip Code _____________________ Daytime Phone ____________________________________________ Cell Phone _________________________________________________ E-mail _____________________________________________________ Men’s T-shirt Size ___________________________________________ Women’s T-shirt Size ________________________________________ Dietary Restrictions _________________________________________ Cost: TBD Please make checks payable to Fairfield University or pay online at www.fairfield.edu/publicsafety Cancellation fees may apply Purchase Order Number: ___________________________________ F A I R F I E L D U N I V E R S I T Y O F P U B L I C S A F E T Y D E P A R T M E N T Saturday, July 23 - Friday, July 29, 2016 “Awesome program, unlike any other training I attended.” “Great comprehensive academy for all security professionals.” “Far exceeded my expectations.” About the Town of Fairfield While attending the Campus Public Safety Officer Training Academy, you can take advantage of the many amenities of our quaint, seaside town! Fairfield University’s scenic 200-acre campus is located in the historic coastal community of Fairfield. Founded in 1639 and with a suburban population of nearly 57,000, the town of Fairfield has a thriving downtown area just one mile from campus. The downtown area offers Fairfield summer residents and visitors many retail stores, restaurants, entertainment venues and five miles of Long Island Sound coastline. Fairfield University is conveniently located one mile from I-95 and the Merritt Parkway. A Metro North railroad station, located downtown, provides convenient transportation south to New York City, a little over one hour away, and north to New Haven, about 30 minutes away. Campus Public Safety Officer Training Academy