Form DPS802-07257 "Application to Be a Recognized Law Enforcement Officers' Safety Act (Leosa) Instructor" - Arizona

What Is Form DPS802-07257?

This is a legal form that was released by the Arizona Department of Public Safety - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2020;
  • The latest edition provided by the Arizona Department of Public Safety;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DPS802-07257 by clicking the link below or browse more documents and templates provided by the Arizona Department of Public Safety.

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Download Form DPS802-07257 "Application to Be a Recognized Law Enforcement Officers' Safety Act (Leosa) Instructor" - Arizona

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ARIZONA DEPARTMENT OF PUBLIC SAFETY
APPLICATION TO BE A RECOGNIZED LAW ENFORCEMENT
OFFICERS’ SAFETY ACT (LEOSA) INSTRUCTOR
Return the completed application to:
Arizona Department of Public Safety
P.O. Box 6488
Phoenix, AZ 85005-6488
Or Fax to: (602) 223-2928
Or E-mail to:
ccw@azdps.gov
- Attn: LEOSA
Please type or print legibly
LEOSA INSTRUCTOR INFORMATION
NAME (LAST, FIRST, MIDDLE)
SOCIAL SECURITY NUMBER (OPTIONAL)
MAILING ADDRESS
CITY
STATE
ZIP CODE
PHONE NUMBER
FAX NUMBER
E-MAIL ADDRESS
AZPOST CERTIFIED FIREARMS INSTRUCTOR?
NAME OF LAW ENFORCEMENT AGENCY
 Yes
 No
LEOSA TRAINING ORGANIZATION INFORMATION
NAME OF TRAINING ORGANIZATION
POST INFORMATION ON DPS WEBSITE?
 Yes
 No
MAILING ADDRESS
CITY
STATE
ZIP CODE
PHONE NUMBER
FAX NUMBER
E-MAIL ADDRESS
FOR DPS USE ONLY
RECEIVED
ENTERED
DATE
BADGE
DATE
BADGE
INSTRUCTOR # ASSIGNED
WEBSITE UPDATED
DATE
BADGE
DATE
BADGE
Phoenix (602) 256-6280 *** Outside metropolitan Phoenix, but within Arizona 1-800-256-6280 *** Fax (602) 223-2928
Business hours 8:00 – 5:00 Monday through Friday
www.azdps.gov/ccw
DPS 802-07257
Rev. 3-2020
ARIZONA DEPARTMENT OF PUBLIC SAFETY
APPLICATION TO BE A RECOGNIZED LAW ENFORCEMENT
OFFICERS’ SAFETY ACT (LEOSA) INSTRUCTOR
Return the completed application to:
Arizona Department of Public Safety
P.O. Box 6488
Phoenix, AZ 85005-6488
Or Fax to: (602) 223-2928
Or E-mail to:
ccw@azdps.gov
- Attn: LEOSA
Please type or print legibly
LEOSA INSTRUCTOR INFORMATION
NAME (LAST, FIRST, MIDDLE)
SOCIAL SECURITY NUMBER (OPTIONAL)
MAILING ADDRESS
CITY
STATE
ZIP CODE
PHONE NUMBER
FAX NUMBER
E-MAIL ADDRESS
AZPOST CERTIFIED FIREARMS INSTRUCTOR?
NAME OF LAW ENFORCEMENT AGENCY
 Yes
 No
LEOSA TRAINING ORGANIZATION INFORMATION
NAME OF TRAINING ORGANIZATION
POST INFORMATION ON DPS WEBSITE?
 Yes
 No
MAILING ADDRESS
CITY
STATE
ZIP CODE
PHONE NUMBER
FAX NUMBER
E-MAIL ADDRESS
FOR DPS USE ONLY
RECEIVED
ENTERED
DATE
BADGE
DATE
BADGE
INSTRUCTOR # ASSIGNED
WEBSITE UPDATED
DATE
BADGE
DATE
BADGE
Phoenix (602) 256-6280 *** Outside metropolitan Phoenix, but within Arizona 1-800-256-6280 *** Fax (602) 223-2928
Business hours 8:00 – 5:00 Monday through Friday
www.azdps.gov/ccw
DPS 802-07257
Rev. 3-2020