The NJ Police Chief Magazine Volume 25, Number 6 | Page 20

NEW JERSEY STATE ASSOCIATION OF CHIEFS OF POLICE 09 December — 15 December 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 ******** REGISTRATION FORM 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 ******** COST: $1,900 per attendee Name: ______________________________________________________________________ Rank/Title: ______________________________________________________________________ Agency: ______________________________________________________________________ Address: ______________________________________________________________________ City: ___________________________________ State: _________ Zip: _____________ E-Mail: _________________________________________________________________________ PAYMENT: Form of Payment: Check ___ Purchase Order ___ Credit Card: __Visa __ Mastercard __ AMEX Credit Card #: _____________________________________ Exp. Date: ________ CC Code _______ Billing Address: ______________________________________________________________________ City/State/Zip: _______________________________________________________________________ ________________________________________ Signature ____________________ Date 19