response to numerous requests, the NGCRC now takes all major credit cards, defined
specifically as the "big four": Visa, Master Card, Discover Card, and American
Express. Fill out the registration form, and fax it to the NGCRC: the fax number
for the NGCRC is (708) 258-9546
A registration form appears below:
THE 2015 NGCRC's 18th INTERNATIONAL
GANG SPECIALIST TRAINING PROGRAM
REGISTRATION FORM: July 31, 2015
Please PRINT neatly or type your full name with any title that you want to appear in your official name badge for the conference.
I.D. Badge Information:
MAIL AND CONTACT INFORMATION: Where we will mail you a Confirmation of Registration letter for the conference, and fax the same material to you:
City, State, Zip:____________________________________________________
Tel. #. Area Code_______ Tel #:____________________
Fax #. Area Code_______ Fax #:____________________
The NGCRC reserves the right to refuse service to anyone: Towards this end we must ask that all persons registering for the conference sign and by their signature acknowledge the Official Policy of the NGCRC which is as follows - In order to provide the safest and most educational environment, the National Gang Crime Research Center (NGCRC) works to ensure that all participants at our conference are law-abiding individuals who have gathered to collect and share information about gangs and crime, in order to reduce and possibly eliminate the problems associated with gang activity. Therefore, it is our policy that no individuals or groups will be permitted at our conference who have links to gangs or other aberrant groups and no one will be permitted to provoke or distract our participants from the most meaningful learning environment. The National Gang Crime Research Center (NGCRC) reserves the right to refuse attendance to any person or persons suspected of or actually displaying gang affiliations. Furthermore, we reserve the right to refuse attendance to any individual(s) determined to be disruptive or instigating a negative or inappropriate presence or who is determined to disrupt the sharing of information in the most effective learning environment. I have also read and understand the refund policy published by the NGCRC. I attest that I am at least 18 years of age as of this date.
I hereby acknowledge by my signature the above policies of the NGCRC:_________________________________________________________________________________________________
I would like to attend the Christian Gang Specialist Reception ___Yes ___No (if blank, we assume you mean "NO")
I work in either law enforcement or corrections and I would like to attend the Law Enforcement and Corrections Networking Reception: ____Yes ____No (if blank, we assume you mean "NO")
I want to attend the Intervention/Prevention/Counseling Gang Specialist Networking Reception ____Yes ____No (if blank, we assume you mean "NO")
I would like to attend the Veteran's Reception ____Yes ____No (if blank, we assume you mean "NO")
I want to attend a baseball networking event Tuesday evening ____Yes _____No (if blank, we assume you mean "NO)
I want to attend the full Mental Health First Aid (MHFA) Certification Course (12 of my 24 hours) at this training conference. ___Yes ___No
I am registering for (check appropriate box):
___Non-certification ___Certification ___One Day Pass (pick which day: ___Monday ___Tuesday ___Wednesday)
If registering for Certification, Complete this section ONLY if you have previously been Certified by the National Gang Crime Research Center at any of the previous NGCRC International Gang Specialist Training Conference(s). I received NGCRC certification from (check one or more as may apply in your situation):
International ___Second International ___Third International ___Fourth International
___Fifth International ___Sixth International ___Seventh International ___Eighth
International ____Ninth International ____Tenth International ___Eleventh International
___Twelfth International ___Thirteenth
International ___Fourteenth International ___Fifteenth International
____Sixteenth International ____Seventeenth International
SPECIAL TRAINING TRACKS (If you are registering for Certification, you also need to complete this section): CHECK ONE ONLY (this is for your second certificate described elsewhere in this brochure):
_____ Gang Crime Investigation Skills Track
_____ Gang Homicide Investigation Skills Track
_____ Domestic Counter-Terrorism Skills Track
_____ Gangs and Mental Health Track
_____ Gang Profile Analysis Track
_____ Gang Interview/Interrogation Skills Track
_____ Gangs and Drugs Track
_____ Gang Prosecution Track
_____ Corrections Gang/STG Intelligence Track
_____ Gang Prevention Skills Track
_____ Gang Problems in K-12 Schools Track
_____ Faith-Based Programs for Gang Intervention Track
_____ Officer Safety Skills in Dealing With Gangs Track
_____ Gang Counseling Techniques Track
_____International and Transnational Gang Problems
_____Gangs and Organized Crime
_____ Gang Arson Investigation Skills Track
_____ Hate Group/White Racist Extremist Gangs Track
_____ Dealing With Gang Members in Probation/Parole Track
_____ Advanced Gang Identification
_____ Gang Internet Investigation
_____ Management and Supervision Skills for Gang Specialists
_____ Motorcycle Gangs (restricted to Law Enforcement ONLY)
_____Gang Program Grantwriting/Fundraising Skills
_____Gangs and the Mass Media
_____Gang Crime Analysis & Mapping Skills
_____Dealing With Gangs in Juvenile Correctional Facilities
_____Gang and Violence Prevention for School Administrators
_____Gangs in the Military
_____ Graffiti Identification and Analysis
_____Management Skills for Gang Outreach, Prevention and Intervention Services
_____Gang Outreach and Intervention Skills
Your registration fee does not cover your hotel room or transportantion or parking or meals. Your registration fee covers only the training itself.
Amount to pay for Registration (see schedule below):
REGULAR REGISTRATION PERIOD:
Paying on or before July 31, 2015: Non-Certification $800, Certification $850
LATE REGISTRATION PERIOD:
Paying on or after August 1, 2015 and on or before August 8th, 2015: Non-Certification, $900, Certification $950
ONSITE REGISTRATION: An Onsite Registration is any registration made on or after August 9, 2015.
Paying On-Site (If slots are available): Non-Certification $950, Certification $1000
Price for the One-Day Pass: $395 per day.
You need to specify which day: ___Monday ___Tuesday ___Wednesday
I am signing up for the Double Major option (where I get two certificates in the two different specialty areas, it requires me to log-in at least four hours in each track or specialty area, and I have enclosed an extra $90 for this option). ____Yes ____No
If yes regarding the Double Major, my second training track will be: (fill it in here)______________________________________________________________
Note anyone registering on-site: we reserve the right to refuse on-site registration to anyone for any reason. You will need USC, money order, traveler’s checks, bank check, cashier's check, or government agency check to pay onsite.
Note: you know you are registered for the conference if and only if you receive from the NGCRC an official “Conference Registration Confirmation” letter; we send these out PROMPTLY to all persons; so if you have not received one, you are not registered.
NOTE: Payment must be received by the NGCRC prior to the conference itself unless the NGCRC agrees to the terms of any alternative arrangement (in writing)..
Group Discount Code:_____________
PAYMENT METHOD: We prefer checks or money orders for payment. No personal checks will be accepted for on-site payment of conference registration fees. We do accept credit card payments.
_____Payment enclosed in check or money order made payable to "National Gang Crime Research Center"
_____VISA, MasterCard, American Express or Discover (Circle one).
Expiration date: Month___________________________ Year:_________________________________
Name on card: (printed):___________________________________________________________________
Your Signature:________________________________ Amount you authorize to charge (total):__$______________
Address for the card holder(Printed): (street address)__________________________________________________________
Zip Code for the Billing Address:__________________________________
Call (708) 258-9111 if you need the NGCRC F.E.I.N. (tax number) or our Merchant Number for credit card payments. Also, call (708) 258-9111 if you want to provide credit card info by verbal rather than written transmission.
Registration forms can be faxed to the NGCRC, the Fax Number is (708) 258-9546.
Registration forms can be emailed to the NGCRC, the email address is: firstname.lastname@example.org
(you can always elect to "call in" the credit card number if you are paying by credit card).
Make checks or money orders payable to "National Gang Crime Research Center". Make sure to mail a copy of your registration with the payment so that proper credit can be made to your registration. Send registration forms and payment to: The 2015 Conference Processing Center, National Gang Crime Research Center, PO Box 990, Peotone, IL 60468-0990.