FACCI Training Registration Form

2009

Name: ________________________

Agency: __________________________

Title: _________________________

Phone: ___________________________

Address: ______________________

City/State/Zip: _____________________

Please indicate method of payment: (Make checks payable to FACCI, Inc.)

_______ Payment enclosed

_______ Will pay day of conference

Cost:

If PAYMENT is received on or before July 24, 2009:
    Members: $150.00, Non-members: $190.00

For payment at the conference or via purchase order:
    Members: $200.00, Non-members: $250.00

FACCI FEID# 59-3135944

Please mail registration forms to:

Florida Association of Computer Crime Investigators, Inc.
P.O. Box 1503
Bartow, Fl. 33831-1503

email to: info@sacci.org

PLEASE NOTE: Attendance is limited to members of FACCI and those that would qualify for membership. (See the Bylaws section of the web site for information about FACCI membership qualifications.) Please email info@facci.org if you have questions.