LOUISIANA JUVENILE OFFICERS ASSOCIATION 2008 CONFERENCE REGISTRATION APPLICATION ALEXANDRIA, LOUISIANA APRIL 14 - 18, 2008 ALL INFORMATION IS KEPT CONFIDENTIAL WE DO NOT SHARE YOUR PERSONAL INFORMATION NAME: __________________________________________ RANK: __________________________________________ HOME ADDRESS: __________________________________________ __________________________________________ HOME PHONE __________________________________________ ****************************** DEPARTMENT OR AGENCY NAME AND ADDRESS: __________________________________________ __________________________________________ __________________________________________ WORK PHONE # _________________ CELL# _________________ CONFERENCE FEES BELOW INCLUDE A T-SHIRT AND A BANQUENT FEE. IF YOU WOULD LIKE TO PURCHASE AN ADDITIONAL T-SHIRT AND OR BRING AN ADDITIONAL PERSON TO THE BANQUENT PLEASE SEE BELOW: T-SHIRT SIZE : S M L XL XXL XXXL XXXXL CONFERENCE FEE: $100.00 ADDITIONAL T-SHIRT $10.00 X ____ _______ ADDITIONAL BANQUENT $15.00 X _____ _______ TOTAL ENCLOSED $ __________________ MAIL TO:
Louisiana Juvenile Officer's Association P.O. Box 461 Alexandria, LA. 71309 IF YOU WOULD LIKE TO RECEIVE AN INFORMATION PACKET ON THE CONFERENCE PLEASE EMAIL REQUEST TO info@ljoa.org PACKETS WILL BE MAILED AFTER DECEMBER 2007 WITH AGENDA |
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