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 : ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
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 : ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
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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