The NJ Police Chief Magazine Volume 24, Number 8 | Page 25

NEW JERSEY STATE ASSOCIATION OF CHIEFS OF POLICE Police Executive Institute – 18 th Session Monday, 08 April 2019—Friday, 12 April 2019 MAKE CHECKS / PURCHASE ORDERS PAYABLE TO AND SEND TO: New Jersey State Association of Chiefs of Police 751 Route 73 North , Suite 12 Marlton, NJ 08053 P/ 856-334-8943 F/ 856-334-8947 E/ [email protected] REGISTRATION FORM Name: ______________________________________________________________________ Rank/Title: ______________________________________________________________________ Agency: ______________________________________________________________________ Address: ______________________________________________________________________ City: ___________________________________ State: _________ Zip: _____________ Phone/Fax/E-Mail: ________________________________________________________________ Form of Payment: Check ___ Purchase Order ___ Credit Card: __Visa __ Mastercard __ AMEX Credit Card #: _____________________________________ Expiration Date: _________________ CC Security Code: _____________ Billing Address: ___________________________________________________________________ City/State/Zip: ____________________________________________________________________        ******************************* Deadline for Registration: March 11, 2019 [space permitting] Registration Fee: $950– Please make checks payable to NJSACOP The 2019 NJSACOP Police Executive Institute will be held at: The National Conference Center & Holiday Inn , 399 Monmouth Street, East Windsor, NJ Registrants will receive a confirmation prior to the course Please duplicate this Registration Form for each registrant Registrations must be paid in advance by check or purchase order Cancellations must be received by March 15, 2019 in order to receive refund. ________________________________________ Signature ____________________ Date 24