The NJ Police Chief Magazine Volume 23, Number 4 | Page 15

New Jersey State Association of Chiefs of Police
105 th Annual Training Conference
June 26 – June 29, 2017
Resorts Casino Hotel & The Atlantic City Convention Center
REGISTRATION FORM
Attendee Information:
Title & Name___________________________________________________________________________________________________
Agency________________________________________________________________________________________________________
Address_______________________________________________________________________________________________________
City, State, Zip__________________________________________________________________________________________________
Email (required for Confirmation)_____________________________________________________________________________________
County__________________________________
Spouse/Companion Information - shared for spouse events at convention
If attending ALL events – see below for list of events:
Name________________________________ Email_____________________________________________ Phone__________________
ADDITIONAL Banquet tickets:
$125 per ticket
Quantity________
Full registration fees include Banquet ticket; do not order if you register in full below.
Child(ren) (if under 18, no fees apply):
Name(s)_______________________________________________________________________________________________________
Member Status/Fees:
Active [ ]
$345
Non-Member [ ] $365
L.E. Associate [ ] $345
Retired [ ]
$185
P.S. Affiliate [ ]
Late fee [ ]
Fees include: Host Chiefs Night, Tuesday & Wednesday Breakfasts/Seminars, Installation Banquet
$345
$25 if registering after 6/21/17
Spouse Status/Fees:
Active, L.E. Assoc., P.S. Affiliate, Non-Member [ ] $195
Retired [ ] $140
Fees include: Host Chiefs Night, Tue