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Please enter information exactly as it should appear in the Vendor Directory.


Company
Address
City/State   Zip  
Contact Name
Telephone   Fax Number 
E-Mail Address
Web Address

Company representatives at conference: (Please print names exactly as name badges should be prepared.) Booth fee includes 2 company representatives; additional reptresentatives may register for $35 each.
1    Complimentary
2    Complimentary
3    $35 
4    $35 
5    $35 

REGISTRATION INFORMATION: Booths are sold and assigned on a first come/first serve basis. Click here to check the booth layout for availability. Questions? Please call 1-800-332-8117.

Booth # Requested   Alternate # 1   Alternate # 2  

Booth Type?  Portable  Table Top   

Electric Needs?    1-3 amps. (free)    4-6 amps.(+$20)       7-10 amps.(+$35)    None.  

Special Needs?         
Product Description:

Are you donating a door prize?  Yes   No   
Interested in being a sponsor?   Yes    No   

Who should we contact about a sponsorship?  

Phone Number

Number of Booths?  @$399 = 
Electric Upgrade?  @$20 or $35 = 
Additional Reps?  @$35   = 
Deposit  @$100 Per Booth       Due November 13, 2000
Amount Enclosed    
Balance     Due December 13, 2000
PLEASE NOTE: all cancellations are subject to a $65 administrative fee. Sorry, but no refunds will be given after January 1, 2001.

Payment Method:     Check   Check number      Visa      Mastercard 
Card #         Expiration   Name on Card 
Signature 

RETURN COMPLETED FORM WITH PAYMENT TO: Florida Police Chiefs Association, Fax Number (850) 219-3640 or mail to- Conference Registration, P.O. Box 14038,Tallahassee, FL 32317-4038

The undersigned hereby authorizes FPCA to reserve exhibit space in the World Golf Village Resort Hotel, St. Augustine, FL, for use by above company/organization during the 2000 Mid-Winter Conference. The undersigned agrees to abide by the Exhibit Rules and Regulations and contract and ensures that all representatives working in the booth are aware of the terms, conditions and rules pertaining to the exhibition.

Authorized Signature   Date  
Print/Type Name   Title 

FOR FPCA USE
Date Recieved    Booth#  

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