The NJ Police Chief Magazine Volume 24, Number 2 | Page 16

New Jersey State Association of Chiefs of Police
106 th Annual Training Conference
June 25 – June 28, 2018
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:
DO NOT REGISTER SPOUSE/COMPANION IF THEY WILL NOT ATTEND ALL EVENTS AS LISTED BELOW
Name_______________________________________ Email (required for event notification)______________________________________
ADDITIONAL Banquet tickets:
$135 per ticket
Quantity_____
FULL registration fees include Banquet ticket; do not order if you register in FULL below.
Child(ren) (18 and under--no fees apply):
Name(s)_______________________________________________________________________________________________________
Member Status/Fees:
Active-Chiefs only [ ] $365
Non-Member [ ] $385
L.E. Associate [ ] $365
Retired [ ] $185
P.S. Affiliate [ ] $365
Late fee [ ] $35 if registering after 6/21/18
Fees include: Host Chiefs Night, Tuesday & Wednesday Breakfasts/Seminars, Installation Banquet
Spouse Status/Fees:
Active, L.E. Assoc., P.S. Affiliate, Non-Member [ ] $205
Retired [ ] $140
Fees include: Host Chiefs Night, Tuesday & Wednesday Breakfasts/Seminars, Special Spouse Event(s), Installation Banquet
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Attendee fee -
$____________
Fee Totals:
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 registration form 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/vnjc18 OR CALL DIRECT: 888-797-7700 & USE CODE VNJC18
Please use the Breakfast/Seminar Registration Form to add additional personnel for Tuesday & Wednesday.
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