Florida Police Chiefs Association - FPCA OnLine: 2007 Summer Conference

Hyatt Regency Jacksonville Riverfront
225 East Coast Line Drive
Jacksonville, FL 32202
Call for Hotel Reservations at (904) 588-1234 or Fax Hotel Reservations to (904) 634-4554.

Chief Executive or Initial Registrant (FPCA Member) - $300 (if registered by May 23 - $350 thereafter). Includes one ticket to Host Chief's Night, Installation Banquet, and Farewell Breakfast. (Please print/type name as you would like your badge to read.) 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

Telephone:    Fax     E-Mail

ActivitiesI plan to participate in the Golf Tournament on Sunday? Yes No

Spouse - $75 (if registered by May 23 - $95 thereafter).
Includes one ticket to Host Chief's Night, Installation Banquet, and Farewell Breakfast.

Spouse's Name:

Youth(s) - $50 (if registered by May 23 - $70 thereafter).
Includes tickets to Host Chief's Night and Farewell Breakfast. Tickets for the Installation Banquet must be purchased separately.

Name & Age:

Name & Age:

Name & Age:

Additional Staff (FPCA Member(s) - $250 (if registered by May 23 - $300, thereafter).
Includes one ticket to each event. (Please print/type name as you would like your badge to read.)

Name

Rank/Title

Department/Agency

Non FPCA Member(s) - $350 (if registered by May 23 - $400, thereafter).
Includes one ticket to each event. (Please print/type name as you would like your badge to read.)

Name

Rank/Title

Department/Agency

Payment Information:

Payment Type:

Purchase Order #:

Credit Card#:

Expiration Date:

Name on Credit Card:

Signature:

Billing Address:

Hotel Information:
Hotel accommodations will be handled directly by the Hyatt Regency Jacksonville Riverfront. Call for Reservations at (904) 588-1234 or Fax Reservations to (904) 634-9988 and please mention that you are with the Florida Police Chief's Association. Be sure to call no later than May 23, 2007, to guarantee your room rate of $116 per night which will be honored three days prior and 3 days after the conference. Click here for additional details about the Hyatt Regency Jacksonville Riverfront. Click Here for Driving Directions from Yahoo Maps.
Print & MAIL or FAX completed form to:
FPCA, Conference Registration, P.O. Box 14038, Tallahassee, FL 32317, Fax: 850-219-3640.