New Jersey State Association of Chiefs of Police 105 th Annual Training Conference June 26 – June 29, 2017 Resorts Casino Hotel & The Atlantic City Convention Center REGISTRATION FORM
Attendee Information:
Title & Name ___________________________________________________________________________________________________ Agency ________________________________________________________________________________________________________ Address _______________________________________________________________________________________________________ City, State, Zip __________________________________________________________________________________________________ Email( required for Confirmation)_____________________________________________________________________________________ County __________________________________
Spouse / Companion Information- shared for spouse events at convention If attending ALL events – see below for list of events:
Name ________________________________ Email _____________________________________________ Phone __________________
ADDITIONAL Banquet tickets: $ 125 per ticket Quantity ________
Full registration fees include Banquet ticket; do not order if you register in full below.
Child( ren)( if under 18, no fees apply): Name( s)_______________________________________________________________________________________________________
Member Status / Fees: Active [ ] $ 345 L. E. Associate [ ] $ 345 P. S. Affiliate [ ] $ 345 Non-Member [ ] $ 365 Retired [ ] $ 185 Late fee [ ] $ 25 if registering after 6 / 21 / 17 Fees include: Host Chiefs Night, Tuesday & Wednesday Breakfasts / Seminars, Installation Banquet
Spouse Status / Fees: Active, L. E. Assoc., P. S. Affiliate, Non-Member [ |
] $ 195 |
Retired [ |
] $ 140 |
Fees include: Host Chiefs Night, Tuesday & Wednesday Breakfasts / Seminars, Special Spouse Event( s), Installation Banquet |
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Fee Totals: |
Attendee fee- |
$____________ |
Spouse fee-
$____________ Banquet ticket( s)- $____________ Late fee- $____________ TOTAL AMOUNT DUE- $____________
Make Purchase Orders / Checks payable to: New Jersey State Association of Chiefs of Police
Return completed registration form along with payment information to: NJSACOP- 751 Route 73 North, Suite 12- Marlton NJ 08053 Tel- 856 / 334-8943 Fax- 856 / 334-8947
Credit card info- CC #__________________________________________________________ Expiration date _______ /________ 3 or 4 digit CVV ___________ Amount to be charged- $________________ Signature ____________________________________________________________________ Address of CC holder _______________________________________________________________________________________________
Hotel room reservations can be made here: https:// meetatresortsac. com / vnjc17 OR CALL DIRECT: 888-797-7700 & USE CODE VNJC17
Please use the Breakfast / Seminar Registration Form to add additional personnel for Tuesday & Wednesday.
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