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2011 Mid-Winter Training Conference & Exposition

Member/Guest Registration Form

Chief Executive or Initial Registrant (FPCA Member) - $225 (If registered by December 8, 2010 - $250 thereafter). Non Member - $275.00 (If registered by December 8, 2010 - $300.00 thereafter). Please print/type name exactly as you would like your badge to read. Registration fee is due upon receipt. Cancellation Policy:  30 days or more notice, will result in a refund less a $100 administrative fee. No refunds will be issued if a cancellation is made with less than 30 days notice.

Name:
Rank/Title:
Department/Agency:
Address:
City/State/Zip:
County:
E-mail:
Telephone:
Fax:
Registration Fee:

Spouse Registration - $75 (Must register by December 8, 2010).
Includes admittance to Exposition Reception, Member Meet & Greet and all food and beverage events.  Registration fee is due upon receipt.

Spouse's Name:

Additional Command Staff Member (FPCA Members) - $175 (If registered by December 8, 2010) $225 thereafter. Non Member Command Staff - $225 (If registered by December 8, 2010 - $250 thereafter). Registration fee is due upon receipt.  Please print/type name exactly as you would like your badge to read.

Name
Rank/Title
Department/Agency
Registration Fee:

Spouse Registration - $75 (Must register by December 8, 2010.
Includes admittance to Exposition Reception, Member Meet & Greet and all food and beverage events.  Registration fee is due upon receipt.

Spouse's Name:

PAYMENT INFORMATION:

Payment Type:
Purchase Order #:
Credit Card#:
Expiration Date:
Name on Credit Card:
Billing Address:

Please print and fax your completed form to the Florida Police Chiefs Association at 850-219-3640.
Questions?  Call us at 850-219-3631.

Hotel Information:   The conference will be held at the Renaissance Resort at World Golf Village which is located directly off Interstate 95 at 500 South Legacy Trail, St. Augustine, Florida 32092.  Call (904) 940-8000 for HOTEL Reservations. Be sure to mention that you are with the Florida Police Chiefs Association.  Our room rate is guaranteed at $136 per night, providing that you register no later than December 8, 2010.
Click Here for Driving Directions from Yahoo Maps.

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