S.E.I. SERVICES 7144 S. Normal Blvd. Chicago IL. 60621 773-952-4051 (Phone) 773-952-4379 (Fax) TRAINING ACADEMY ENROLLMENT FORM Class Title: __________________________________     Class#: ___________ Class Date: ___________     Student ID#: ___________ Name: __________________________________     SS#: ___________________ Address: __________________________________ Phone#: ___________________     Cell Phone#: ___________________ Emergency Contact: _____________________________________________________ Highest Level of Education: ___________     Tuition Amount: ___________ I ________________________________ SHALL HOLD S.E.I. SERVICES, IT'S INSTRUCTORS AND EMPLOYEES HARMLESS AS TO ANY INJURIES OR DAMAGES INCURRED BY SAID TRAINEE AS A RESULT OF SUCH SECURITY TRAINING, FUNCTIONS AND OTHER ACTIVITIES SANCTIONED BY S.E.I. SERVICES REGARDLESS OF FAULT OF NEGLIGENCE ON PART OF ANY OFFICIALS OR EMPLOYEES OF S.E.I. SERVICES I HAVE BEEN INFORMED THAT ALL INFORMATION, HANDOUTS, LECTURES, AND FILMS ARE ONLY AN OVERVIEW OF THE CLASS TOPICS. ________________________________________________________      ______________ STUDENT SIGNATURE                                                                              DATE ________________________________________________________      ______________ S.E.I SERVICES STAFF SIGNATURE                                                        DATE ============================================================= For Office Use Only DID THE STUDENT PASS THE EXAM Y OR N _____ TUITION PAID Y OR N CERTIFICATE ISSUED Y OR N _____ TOTAL CREDITS EARNED _____ [PRINT THIS FORM AND FAX TO (773) 952-4379] or Mail to: The Above Address (Top of Page) -- or You may Email this Form to seidirector@hotmail.com     Click Here to Go To Home Page