The NJ Police Chief Magazine Volume 24, Number 6 | Page 9

DATE & LOCATION: Thursday, October 18, 2018 The National Conference Center & Holiday Inn 399 Monmouth Street East Windsor, NJ 08520 Please complete the information below and return this form to the NJPCF State Office via fax, mail or e-mail. TIME: 9:00 am to 3:30 pm 8:30 am Registration and Continental Breakfast REGISTRATION FEE: $215.00 per person * Continental breakfast and luncheon included in registration New Jersey Police Chiefs Foundation 751 Route 73 North, Suite 12 Marlton, NJ 08053 P: 856-334-8943 F: 856-334-8947 [email protected] (The New Jersey Police Chiefs Foundation is the official charitable affiliate of the New Jersey State Association of Chiefs of Police) MAKE CHECKS / PURCHASE ORDERS PAYABLE TO: NEW JERSEY POLICE CHIEFS FOUNDATION Name: _____________________________________________________________________________________ Rank/Title: _________________________________________________________________________________ Agency/Department/School: ___________________________________________________________________ Address: ___________________________________________________________________________________ City/State/Zip: ______________________________________________________________________________ Phone: _____________________________ E-mail: _________________________________________________ Form of Payment: Check ___ Purchase Order ___ Credit Card: __Visa __ Mastercard __ AMEX Credit Card #: _______________________________________Expiration Date: ___________ CVV: ___________ Billing Address: ______________________________________________________________________________ City/State/Zip: ______________________________________________________________________________ Signature: __________________________________________________________________________________ 8