Offices of Attorneys General Bill McCollum and Thurbert E. Baker

23rd National Conference on
Preventing Crime in the Black Community

June 19 - 22, 2008 in Tampa, Florida
[Home] | [Details] | [Schedule]

CONFERENCE REGISTRATION FORM
First Name: *
MI:
Last Name: *
Salutation:
(If Other):
Age Group: Teen College Student Adult*
Job Title:
Agency:
County:
(If Other):
Street Address: *
City: *
State: *
Zip Code:
 *
(If Other):
Phone:
E-Mail Address:

Are you a sworn law enforcement officer? Yes No

Please describe any special accommodations that you may require to participate in the conference pursuant to the Americans with Disabilities Act (ADA):



* Indicates that a field is required to be filled out.