Education Workshop

Online Registration for 2012 Workshops

Education Workshop/Conference Registration Form Submit Date:

Last Name: First Name:

Rank: Department:

Address: City: State: Zip:

Phone: Fax: Email:

Are you a CLEE Graduate? Yes No

Workshop:

Need an invoice? Yes No

NOTE: Please make checks payable to Ohio Association of Chiefs of Police (for all workshops)

Send confirmation/invoice to the attention of and email

PO # (if applicable):

If you are requesting double occupancy for another workshop attendee, please list roomate's name:

Bringing a spouse/guest? Yes No
PLEASE NOTE: This does not apply to one-day workshops
(Includes room and meals only, workshop not included)

Spouse/Guest Name:

If you have any special dietary needs, please let us know

Comments: