Law Enforcement Enrollment Form

[et_pb_section fb_built=”1″ fullwidth=”on” admin_label=”Section” _builder_version=”3.22″][et_pb_fullwidth_header title=”LAW ENFORCEMENT ACCESS” subhead=”To obtain access to the IP Brands Database, you must be a law enforcement officer. Please provide us with the below details, and after verification of credentials, the IPR Center team will give you access to the database.” content_max_width=”none” admin_label=”Fullwidth Header” _builder_version=”3.16″ background_color=”#320f23″ button_one_letter_spacing_hover=”0″ button_two_letter_spacing_hover=”0″ button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”on” button_one_letter_spacing__hover=”0″ button_two_letter_spacing__hover_enabled=”on” button_two_letter_spacing__hover=”0″ button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_fullwidth_header][et_pb_fullwidth_image src=”http://www.iprcenter.com/wp-content/uploads/2016/04/police-registration.jpg” admin_label=”Fullwidth Image” _builder_version=”3.0.87″ animation_style=”slide” animation_direction=”left” animation_duration=”500ms” animation_intensity_slide=”10%” animation=”left” use_border_color=”off” border_color=”#ffffff” border_style=”solid”][/et_pb_fullwidth_image][/et_pb_section][et_pb_section fb_built=”1″ admin_label=”section” _builder_version=”3.22″][et_pb_row admin_label=”Row” _builder_version=”3.25″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_contact_form captcha=”off” email=”vincentvolpi@pica.net” title=”LAW ENFORCEMENT ENROLLMENT ” custom_message=”You have received a LAW ENFORCEMENT message from the IPRCenter. ||et_pb_line_break_holder||||et_pb_line_break_holder||%%FIRSTNAME%% %%LASTNAME%%, %%TITLERANK%%, %%EMAIL%%, %%LAWENFORCMENTAGENCY%% %%BADGENUMBER%% %%PHONE%% %%AGENCYEMAIL%% %%AGENCYPHONE%% %%COMMENTS%%” success_message=”Thank you for your desire to figth counterfeit. We will be in touch shortly.” admin_label=”LAW ENFORCEMENT SIGN UP” _builder_version=”3.26.6″ form_field_background_color=”#ffffff” border_radii=”on|0px|0px|0px|0px” border_width_all=”1px” border_color_all=”#666699″ border_style_all=”solid” custom_button=”on” button_text_color=”#ffffff” button_bg_color=”#666699″ use_border_color=”on” border_color=”#666699″ border_style=”solid” input_border_radius=”0″ form_background_color=”#ffffff” button_letter_spacing_hover=”0″][et_pb_contact_field field_id=”FIRSTNAME” field_title=”FIRST NAME (REQUIRED)” _builder_version=”3.16″ form_field_font=”||||” border_radii=”on||||” use_border_color=”off” border_style=”solid” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” 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button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”TITLERANK” field_title=”TITLE/RANK (REQUIRED)” _builder_version=”3.16″ form_field_font=”||||” border_radii=”on||||” use_border_color=”off” border_style=”solid” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” 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field_id=”EMAIL” field_title=”EMAIL (REQUIRED)” field_type=”email” _builder_version=”3.16″ form_field_font=”||||” border_radii=”on||||” use_border_color=”off” border_style=”solid” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”LAWENFORCMENTAGENCY” field_title=”LAW ENFORCMENT AGENCY (REQUIRED)” _builder_version=”3.16″ form_field_font=”||||” border_radii=”on||||” use_border_color=”off” border_style=”solid” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” 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police-badge

FBI-Badge

$_3

[/et_pb_text][/et_pb_column][et_pb_column type=”2_3″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text admin_label=”Text” _builder_version=”3.0.87″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]

You are requesting to have access to the IPRCENTER proprietary data base. If you are a law enforcement officer (Police, Customs, DEA, FBI, etc.) you are entitled to be granted access.

Nevertheless PICA Corporation, will read your application information and contact your agency to verify that your request is legitimate.

Please fill the form below and send it when done. Note that some fields are mandatory.

Your First Name (required)

Your Last Name (required)

Your Title/Rank

Date

Law enforcement agency (required)

Agency or Office Street Address

Agency or Office City

Agency or Office State

Agency or Office Zip Code

Agency or Office Country

Your Main Phone Number (required)

Alternate/Cell Number

Your Email (required)

Agency email address - Please verify (required)

Choose a password (required)
(minimum 8 characters, must have at least 1 number and at least 1 letter)

Contact Department/Personnel (for verification) (required)

Organization Affiliations

Other Organizations

Please provide any additional information

Thank you. The IPRCENTER team.

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