30th Annual National Gang Violence Conference Registration Form

30th Annual National Gang Violence Conference

July 11 - 15, 2022 (7/11 is an optional training date)
Send confirmation to: *
Email
Attendee's Name *

Last Name First Name
Middle Name
Department Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Agency Phone *
Attendee's Cell Number *
Fax Number
Attendee's Department Email Address *
Please note: each registrant must have his or her own unique email address. A space for the training coordinator's email address is provided below, and those do not have to be unique.
Registration Information
Registrant Type *
Registration Comments
Agency Information
Agency/Organization *
Agency Type
Division/ Station
Unit/Assignment *
Job Title/Rank *
Note: California POST Number is required for any person needing California POST credit.
California POST ID
State and Bar# (For Prosecutors)
Job Description
Job Status *
Training Coordinator
or Contact, if organized by someone other than a training coordinator
T/C Email
or Contact email
T/C Phone Number
Billing Contact *
Include name and best way to contact (phone #, email)
Fees and Payment Information
Conference Options

Conference Fee - Members ($400) Conference Fee - Non-Members ($425) Staff Registration (Free)
We will not establish a waitlist.

Registrations not paid in full by July 1, 2022, are subject to being bumped by a paid conference submission.

Current members are those who attended the 2021 conference or have paid $25 dues in 2021 or 2022.

*Membership will be vetted*
Expected Method of Payment

Check Purchase Order Money Order Credit Card Payment Forthcoming Staff Registration
PO/Check/Money Order#
If known
Send Purchase Orders, Check, or Money Order to the following:

Mail: 5904-A Warner Avenue, #331, Huntington Beach, CA 92649

Attention: Conference Registration

Email: rbanuelos@cgianet.com

Phone: (562) 713-2668
Additional Comments
If you select Credit Card, you can enter your credit card info here for processing. If you want to pay later, select Payment Forthcoming, and print the form if you want a copy.
Calculation

Pay Now

USD Description

Credit Card

Thank you for registering for the 30th Annual National Gang Violence Conference. A confirmation email will be sent after June 1, 2022. Please make sure to check your spam/junk folders if you don't locate it in your primary inbox.
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30th Annual National Gang Violence Conference

Registration Information

Agency Information

Fees and Payment Information

Credit Card