The NJ Police Chief Magazine Volume 23, Number 5 | Page 37

MAIL OR FAX FORM TO: NJSACOP, 751 ROUTE 73 NORTH, SUITE 12, MARLTON, NJ 08053
FAX: [phone]
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(Chief’s Name and Department)
NJSACOP Accredited Agency Logo
(Chief’s Name and Department)
NJSACOP Command & Leadership
Alumni Logo
(Chief’s Name and Department)
$40.00 EACH
PAYMENT INFORMATION
Name: ______________________________________________________________________________________________________________
Shipping Address: ____________________________________________________________________________________________________
City/State/Zip: ________________________________________________________________________________________________________
Phone: ____________________________________________ E-mail: ___________________________________________________________
Credit Card: ___ MC ___ VISA ___ AMEX
CC#: _______________________________________________________________________________________________________________
Exp. Date: _________/_________ CVV (3 or 4 digit code): _____________________________________
Billing Address (if different from above): _________________________________________________________________________________
Signature: ___________________________________________________________________________________________________________
___ Check (payable to NJSACOP)
___ Purchase Order (payable to NJSACOP)
Chief’s Name: __________________________________________________________________________________
Department: ____________________________________________________________________________________
PLEASE CHOOSE YOUR LOGO:
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____ NJSACOP Command & Leadership Alumni Association Logo
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