New Jersey State Association of Chiefs of Police
THREE DAY PROGRAM — SEE AGENDA FOR TIMES AND LOCATIONS . FRIDAY , SEPTEMBER 27 — SUNDAY , SEPTEMBER 29 , 2024 FEE : $ 795
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 registrations @ njsacop . org ********
• 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 .
NAME :
TITLE / RANK / POSITION :
AGENCY / DEPARTMENT :
ADDRESS :
CITY / STATE / ZIP :
TELEPHONE :
FAX :
E-MAIL ADDRESS : ( confirmations will be sent via 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
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