Congratulations to PHILIPS MEDICAL SYSTEMS for being the lucky winner of an exclusive 30 Minute Training Block with the summer conference attendees!

Hilton Daytona Beach Oceanfront Resort
100 North Atlantic Avenue
Daytona Beach, FL 32118
Call for Hotel Reservations at (866) 536-8477 or Fax Hotel Reservations to (386) 253-8841.
Click Here for Driving Directions from Yahoo Maps

Join the Florida Police Chiefs Association and receive 10% off your booth rental. Click Here for Membership Application

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

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

Company representatives at Conference: (Please print names exactly as name badges should be prepared.) The registration fee includes tickets for the first 2 representatives to the following events: Host Chiefs Night, Installation Banquet, and Farewell Breakfast. Additional representatives desiring event tickets are $75 each.

1.    Complimentary

2.    Complimentary

3.    $75

4.    $75

5.    $75

6.    $75

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.

Will you be bringing a vehicle?  Yes   No  
PLEASE NOTE: VEHICLES REQUIRE TWO BOOTHS AND THE HOTEL WILL CHARGE AN ADDITIONAL $500.

Electric Needs?
1-3 amps. (+$20)      4-6 amps. (+$35)    7-10 amps. (+$50)  None. 

Booth # Requested   Alternate # 1    Alternate # 2

Special Requirements?

Product Description: (Please limit to 10 words or less)

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	@$675	=
Number of Booths	@$1425 (Premium 1)	=
Number of Booths	@$1175 (Premium 2)	=
Number of Booths	@$925 (Premium 3)	=
Less 10% for Joining FPCA		=
Additional Reps	@$75	=
Electricity	@$20,$35 or $50	=
$100 Deposit (Per booth)		Due with Registration
Amount Enclosed
Balance		Due May 26, 2006

Please Note: Vehicles require the purchase of two booths. There is an additional HOTEL charge of $500 for vehicle placement. Contact the hotel directly @(386)254-8200 to arrange vehicle placement.

Cancellation Policy: All cancellations are subject to a $100 administrative fee.  Sorry, but no refunds will be given after May 26, 2006.

Payment Type:	Select Type of Payment My Check is in the Mail. MasterCard. Visa. Please Invoice Me.
Credit Card#:
Expiration Date:
Name on Credit Card:
Signature:
Billing Address:

Return form with payment to: Florida Police Chiefs Association, Conference Registration, P.O. Box 14038,Tallahassee, FL 32317-4038 or FAX to 850-219-3640.

The undersigned hereby authorizes FPCA to reserve exhibit space in the Hilton Daytona Beach Oceanfront Resort, Daytona Beach, Florida, for use by above company/organization during the 54th Annual Summer 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

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