The NJ Police Chief Magazine Volume 23, Number 10 | Page 15
NEW JERSEY STATE ASSOCIATION OF CHIEFS OF POLICE
Police Executive Institute – 17 th Session
Monday, 16 April 2018—Friday, 20 April 2018
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: April 01, 2018 [space permitting]
Registration Fee: $950– Please make checks payable to NJSACOP
The 2018 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, 2018 in order to receive refund.
________________________________________
Signature
____________________
Date
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