Page 16 - TPA Journal July August 2023

REGISTRATION FORM

Police & Fire Civil Service Act
Chapter 143, Local Government Code

Sheraton Austin Georgetown Hotel
Georgetown, Texas

November 8 – 9, 2023

Name:
1. Title:
(Please Print)
BAR/TCOLE ID# Email:

2. Title:

BAR/TCOLE ID# Email:

3. Title:

TCOLE ID# Email:

Name of Agency/Organization:

Address:
Street or Box City Zip
Phone: E-Mail

TPA Member Registration ----------------------------------------------------------$250.00
Non-TPA Member Registration----------------------------------------------------$280.00

Total Amount Enclosed--------------------------------------------------$

Return to: Texas Police Association No refunds, replacements welcome.
P. O. Box 4247
Austin, TX 78765-4247 Invoicing is available upon request.
(512) 458-3140
Or Email to: mona@texaspoliceassociation.com

American Express Discover MasterCard Visa

Name (on card):

Card Number: Exp. Date: Sec. Code

Signature: Today’s Date:

CASH CHECK/MONEY ORDER

**Credit Card Fees will be passed along to Registrant.**