TEAM REGISTRATION FORM
2012
Team Name (Agency or Organization)
Contact Person
E-mail
Mailing Address
City
State
Zip
Phone Number Home
Cellular
Pager
TEAM MEMBERS:
NAME
RANK/TITLE
(1) Leader
(2) Officer
(3) Officer
(4) Officer
(5) Officer
(6) Officer
(7) Officer
(8) Officer
Confirmation of registration will be sent via email within 48 hours of registration. If you do not receive a confirmation, please submit your registration again. If you still do not receive a confirmation, please call Ken Roske at 509-736-2396 or email at
policeweekhg@aol.com
.
