DRE Application

	DRE Course Description	Online Application Form

	GHSO Course Descriptions	Download Blank Application
		TTSRS Home

DRE Application & Registration

March 8 - March 19, 2010

If you have submission issues, please print off your completed application and fax to TTSRS at 1.865.974.3889. TTSRS will email you to confirm your submission.

Enter Agency Information

Agency:	Date of Hire:
	(mm/dd/yyyy)

Duty/Assignment:	Precinct:	Vehicle Number:

Address: Use this address	P.O. Box


City:	Zip:
	-

Agency Phone:	Agency Fax:
-

Office Phone:	Office Email: Use this email
-

Supervisor Rank:	First Name:	Last Name:


Email:


Commanding Officer Rank:	First Name:	Last Name:


Email:

Enter Personal Information

Rank:

First Name:

Middle Initial:

Last Name:

Address: Use this address

City:	Zip:
	-

Cell Phone:

Email: Use this email

Enter Background Information

Date of SFST:	Date of Advanced SFST, ARIDE or ARIDE PLUS:	Number of DWI arrests in last years:
(mm/dd/yyyy)	(mm/dd/yyyy)

Summarize your prior assignments related to, or of interest to, the DEC Program:	characters


Summarize your formal education, work or practical experience, and training that may be related to, or may be of interest to, the DEC Program (EMT, college etc.):	characters


How do you expect DRE training to benefit you and your department?:	characters


Anything else that you think would assist in your selection as a DRE?:	characters

Enter Recommendation Information


List two DRE's that would recommend you for DRE training: (They will be contacted if listed.)

First Name:	Last Name:


First Name:	Last Name:



List a local prosecutor that will recommend you for DRE training: (They will be contacted if listed.)

First Name:	Last Name:

Enroll Into Class


	I have read and understand the course description and requirements for the Drug Recognition Expert Class. A email will be been sent to your supervisor and Richard Holt.

For web assistance please contact our HelpDesk at ttsrs@utk.edu.

Tennessee Traffic
Safety Resource Service

Phone: 1.800.99BELTS

www.tntrafficsafety.org