The NJ Police Chief Magazine Volume 23, Number 5 | Page 21

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
BREAKFAST/SEMINAR REGISTRATION FORM
This form to be used for personnel attending the Breakfasts & Seminars only.
$50 per person per day
Agency ___________________________________________________________________________________________________
Address __________________________________________________________________________________________________
City, State, Zip ______________________________________________________________________________________________
Tuesday, June 27, 2017 Breakfast & Seminar
“Ferguson, Missouri: Providing Effective Leadership in a Crisis Situation”
Presented by: Chief Jon Belmar, St. Louis County Police Dept.
Breakfast: 7:45am - 9:00am
Seminar: 9:00am - 12:00pm
Attendee(s) - List by Title & Name:
______________________________________________________________________________________________________
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Wednesday, June 28, 2017 Breakfast & Seminar
“Sustaining Motivation By Being A Transformational Leader”
Presented by: Michael Bret Hood, SA, FBI (Ret.), 21 st Century Learning & Consulting, LLC
Breakfast: 7:45am - 9:00am
Seminar: 9:00am – 12:00pm
Attendee(s) - List by Title/Name:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
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TOTAL # of attendees for both days__________ @$50 each - $_____________
Make Purchase Orders/Checks payable to:
New Jersey State Association of Chiefs of Police
Return completed registration form along with payment information to: NJSACOP - 751 Route 73 North, Suite 12 - Marlton NJ 08053
Tel - 856/334-8943 Fax - 856/334-8947
Credit card info - CC#________________________________________________________________
Expiration date______ /________ 3 or 4 digit CVV_____________
Amount to be charged - $_____________
Signature_______________________________________________________________
Address of CC holder___________________________________________________________________________________________
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