The NJ Police Chief Magazine Volume 25, Number 6 | Page 10

N EW J ERSEY S TATE A SSOCIATION OF C HIEFS OF P OLICE
THREE DAY PROGRAM—SEE AGENDA FOR TIMES AND LOCATIONS.
FRIDAY, OCTOBER 4TH—SUNDAY, OCTOBER 6TH
FEE: $725.00
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PLEASE DUPLICATE THIS FORM FOR EACH REGISTRANT.
REGISTRATIONS MUST BE PAID IN ADVANCE BY CHECK OR PURCHASE ORDER.
YOU WILL RECEIVE AN E-MAIL CONFIRMATION WITH HOTEL INFORMATION PRIOR
TO THE EVENT.
CANCELLATIONS MUST BE RECEIVED 14 BUSINESS DAYS PRIOR TO THE COURSE
IN ORDER TO BE ISSUED A REFUND.
THE SEMINAR MAY BE CANCELED DUE TO INSUFFICIENT ENROLLMENT.
RETURN THIS FORM TO:
NJSACOP
751 ROUTE 73 NORTH, SUITE 12
MARLTON, NJ 08053
FAX #: [phone]
NAME:
TITLE/RANK/POSITION:
AGENCY/DEPARTMENT:
ADDRESS:
CITY/STATE/ZIP:
TELEPHONE:
FAX:
E-MAIL ADDRESS:
(confirmations will be sent via e-mail)
METHOD OF PAYMENT:
___ CHECK ENCLOSED
___ PURCHASE ORDER
CREDIT CARD: ___ VISA ____ MASTERCARD ___ AMEX
CREDIT CARD #: ___________________________________________________________________
EXPIRATION DATE: _______________ CVV: ____________________________________________
BILLING ADDRESS: _________________________________________________________________
______________________________________
SIGNATURE
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DATE
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