Affiliation Verification Form for Individual License Purchase

Thanks for your order! Please complete and submit this form so we can verify your affiliation and get you enrolled. To facilitate this process we will copy you email correspondences with your identified point of contact.

Feel free to email us directly with any questions to info@secondsight-ts.com. We appreciate your business!

 

 
Your Name *
Your Name
Your law enforcement, military, or security-affiliated employer.
Supervisor or administrative contact that can confirm your employment.
POC Phone
POC Phone
Any additional information that would help us verify your affiliation.