Attendee Registration Form

Attendee Registration Form Members & member agencies on or before May 31 Members & member agencies after June 1

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$475 $525

Non members & non member agencies on or before May 31 Non members & non member agencies after June 1

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$525 $575

Members include employees of NCJA or JRSA member agencies, and IJIS Institute members.

Name: Title: Organization: Address: City/State/Zip: Phone: Email:

Payment Method: q

Check/P.O. to NCJA or q

Security Code:

Credit Card #: Expiration:

Signature :

Name on Card (Please Print): Please Note: Registration is not confirmed until payment has been received by the NCJA.

Cancellation Policy:

Send Form To:

Prior to June 16• Full refund After June 16 but before July 7• $100 cancellation fee After July 7 or does not attend the Forum • Registration fee is forfeited

Fax Registration form to (202) 448-1723 or send with payment to National Criminal Justice Association 720 7th Street, N.W., Third Floor Washington, D.C. 20001

All cancellations must be received by the NCJA in writing and must be acknowledged with a cancellation confirmation email.