Student Registration

Complete the form below to register for your security training course. All fields marked with an asterisk (*) are required.

Student Registration – Nelson Security Academy

Complete this form to enroll at Nelson Security Academy.

Student Information

Full Name(Required)

First Last

Date of Birth(Required)

Social Security Number (Last 4 Digits Only)

We only collect the last 4 digits for identity verification purposes.

Driver License or State ID Number(Required)

State Issuing ID(Required)

Contact Information

Email Address(Required)

Mobile Phone(Required)

Home Phone

Preferred Contact Method

Home Address

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Emergency Contact

Emergency Contact Full Name(Required)

Relationship(Required)

Emergency Contact Phone Number(Required)

Course Selection

Select Your Course(Required)

Training Format(Required)

Preferred Class Date

Education Information

Highest Level of Education

Employment Information (Optional)

Current Employer

Current Position

Are you currently employed in security?

How Did You Hear About Us?

How did you find Nelson Security Academy?

Identification Verification

Please upload a government-issued photo ID (Driver License, State ID, or Passport). Accepted: JPG, PNG, PDF. Max 5MB.

Upload Government-Issued Photo ID

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 5 MB.

Required for enrollment verification. You may also bring your ID to class if you prefer.

Student Agreement

By submitting this registration, I certify that:

Agreement 1(Required)

The information I have provided is true and accurate.

Agreement 2(Required)

I understand that course completion does not guarantee the issuance of a Florida license or employment.

Agreement 3(Required)

I agree to follow all Nelson Security Academy school policies and classroom rules.

Agreement 4(Required)

I have reviewed the Privacy Policy, Terms and Conditions, and Refund Policy.

Agreement 5(Required)

I understand that providing false information may affect my enrollment.

Electronic Signature

Student Name (Electronic Signature)(Required)

Typing your full name serves as your electronic signature and confirms your agreement to the statements above.

Date(Required)