Page 14 - November December 2020 TPA Journal
P. 14

TEXAS POLICE ASSOCIATION
                                   Annual Training Conference – June 28 – 30-2021
                                         Texas A & M Hotel and Conference Center
                                                   177 Joe Routt Boulevard
                                                 College Station, Texas  77843
                       Hotel Reservations – (888) 65-GIGEM (44436) – Link TPA Annual Conference


             Name (As to appear on Name Badge):

             Agency                                                   TCOLE PID#

             Address

             City                                               State    Zip

             Contact Phone                              E-Mail

                                 Pre-Registrations are full payments received on or before June 15, 2021.

                           REGISTRATION          PRE-REGISTRATION            LATE & ON SITE        TOTAL
                                                                             REGISTRATION
             Member                              $150.00                     $200.00

             Retired Member                      $75.00                      $125.00

             Spouse/Personal Guest               $50.00                      $50.00

                    Name (As to appear on Name Badge)

             Non-Member or Guest                 $200.00                      $250.00

                    Name (As to appear on Name Badge)

             Youth (12 & Over)                   $50.00                      $50.00

                    Name (As to appear on Name Badge)

             Child 7 – 12                        $25.00                      $25.00
             Child 6 – Under Free
                    Name (As to appear on Name Badge)

             Total Number of Adults that will attending the Banquet on Wednesday, June 30 , 2021.
                                                                                    th

             TPA Membership Dues
                    Active                       $30.00
                    Associate                    $50.00


                                                        TOTAL AMOUNT DUE


              Make Checks Payable and mail to:                    If  you  would  like  to  prepay  using  American  Express,
              Texas Police Association                            Discover, MasterCard, or Visa, fax this completed form
              P O Box 4247                                        to (512) 458-1799.
              Austin, TX  78765-4247

                               American Express          Discover               MasterCard          Visa


                     Name (on card):

                     Card Number:                                        Exp. Date:          Sec. Code

              Signature:                                                Today’s Date:


              Please List Special Assistance/Dietary Needs

                                         Refunds will not be made after June 15, 2021.
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