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Conference Registration

       

Western Colorado Peace Officers Association

Spring Conference 2010

Grand Junction, Colorado

April 28 & 29, 2010

                                                                                 

Registration Form

Please return this form along with your check no later than April 20, 2010.

Make Checks payable to Western Colorado Peace Officers Association and send with this registration form to:

Western Colorado Peace Officers Association

554 Jurassic Court

Fruita, CO  81521

If you have questions, please call Gretchen Olson at (970) 858-2249

or e-mail gretchen.olson@cdps.state.co.us

One form per registrant - copy as needed - please print legibly

Name and Title ________________________________________________________________________

Place of Employment ___________________________________________________________________

Address  _____________________________________________________________________________

Phone Numbers  _______________________________________________________________________

                            Agency Phone                    Direct Line                         Cell Phone                      Other

Field of Specialty  _____________________________________________________________________

                                                Please provide information on your expertise, special training, etc. 

E-mail Address  _______________________________________________________________________

 - Above information will be compiled in a roster and available at the meeting -

Conference Registration Fee

$50 each =

$______

      (Banquet is included in  the registration fee)

Additional Banquet Tickets

$30 each =

$______

      (for guests not attending the conference)

2010 Membership

$20 for New Members

$______

$15 for Renewals

$______

TOTAL PAYMENT ENCLOSED

$______


 
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