Maryland Police and Correctional Training Commissions Registration Form


   PROGRAM NAME:        Current Trends VI“What’s Happening Now……”


                                            LOCATION:           Holiday Inn Express, 1020 Kent Narrows Road

                                                                             Grasonville, MD   21638 (Queen Anne’s County)


                                                    DATE:                        March 30 and 31, 2011          8:00 a.m. – 4:00 p.m.





AGENCY NAME: ____________________________________________________________________


AGENCY ADDRESS: _________________________________________________________________


CITY/STATE: ___________________________________________ ZIP: ________________________


AGENCY CONTACT: ____________________________________ DATE: ______________________


TELEPHONE: ______________________________                 FAX: ______________________________


E-MAIL: ____________________________________________________


The following individual from my agency is being nominated to attend the above referenced training.

NAME (print)                                                                                                           RANK/POSITION




I certify that the above information is true and correct.


___________________________                  ______________________________         ____________

  Signature of Approving Supervisor                                Please Print/Type Name                                      Date


This training is free of charge.  Seating is limited to 65.  In order to accommodate as many departments as possible, MCCPI reserves the right to limit the number of personnel attending from any given department.


MAIL ORIGINAL OR FAX TO: Maryland Police & Correctional Training Commissions

                                                                      Attn: Patricia Sill, MCCPI

                                                                      6852 4th Street

                                                                      Sykesville, MD   21784

                                                                      PHONE:  410-875-3425

                                                                      FAX:       410-875-3420

                                                 PLEASE REGISTER BY MARCH 14, 2011                                                                                                 


Revised July 2008