registration form - Center for American and International Law

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First found Dec 21, 2016

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REGISTRATION FORM
School of Executive Leadership
March 6-April 28, 2017
Mail to: Registrar
Institute for Law Enforcement Administration
5201 Democracy Drive
Plano, Texas 75024-3561
Tuition:
Registrar:
972.244.3404
ILEA Phone: 972.244.3430 or
800.409.1090
Fax: 972.244.3431
E-Mail: [email protected]
$2220 members of the Institute for Law Enforcement Administration
$2520 non-members
This includes all instruction, handouts, books and materials, and a team-building experience at an off-site
facility. Lodging and meals are excluded.
Name/Rank ____________________________________________________________________
Agency/Firm ____________________________________________________________________
Address _______________________________________________________________________
City, State, Zip __________________________________________________________________
Phone _______________________________ E-Mail __________________________________
Payment Information
 Check enclosed payable to: The Center for American and International Law
Check # ___________________________ Check Amount __________________________

Purchase Order attached: #____________________________________________________

Invoice my agency: Attention __________________________________________________
Charge to: ______ MC ______ VISA ______ AMEX
_______ Discover
Card Number _____________________________ Exp __________________ CSV # _________
Name on Card __________________________________________________________________
Billing Address (if different from above address) ________________________________________
_______________________________________________________________________________
_____________________________________________________________________________
Authorized Signature _____________________________________________________________
Cancellation: Tuition, less a $100 handling charge for each registration, will be refunded upon WRITTEN
CANCELLATION received not later than five (5) working days prior to the program (e-mail cancellation notice to
[email protected] No refunds after this date, although substitutions of attendees for this program are permitted.
Nondiscriminatory Policy: The Center for American and International Law does not discriminate on the basis of race,
color, sex, religion, national origin, age, disability, veteran status or any other protected status in educational activities,
scholarship programs or admissions.
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