NCWP Tenth Annual Training Conference
VENDOR/EXHIBITOR PAYMENT FORM
(If registered online, Right Click 
to PRINT this form to make payment 
by check through the mail, or to pay
by credit card through the mail or 
through fax.) 

Exhibitor Booth $500 ______
Police Agency Recruiting Booth $250___

If not registered online, use THE EXHIBITOR FORM
to register and pay, or use the POLICE RECRUITER
FORM
to register and pay.

Name: _____________________________

Company: __________________________

Address: ___________________________

Address: ___________________________

City: ___________ State: ____ Zip: _____

Phone: ____________________________

Fax: ______________________________

Credit Card:
 ___VISA    ___MasterCard    ___American Express

3 or 4-Digit Reference Number: ________   

Card Number: _______________________

Expiration Date: ____________ 

___________________________________________
Card Holder’s Name (Please print)

____________________________________________
Signature of Card Holder

Mail or Fax to:
Maquire White
NCWP 2005 Conference

PO Box 1480
Edgewater, MD 21037-7480
E-Mail:
mwhite@timeandconvenience.com
Telephone: 410-451-0002 ext.202
Facsimile: (410)-451-7373

***********************
List Names below for whom
payment is being made.