Name:_________________________________________________________________________ Agency:__________________________________________________________________ Address:_________________________________________________________________ City:________________________________ State ______________Zip Code:__________ Telephone: Work___________________________________________________________ Conference Shirt Size___________________(Small,Medium,Large,X-Large,XX-Large, XXX-Large) Registration Fee for Conference $275.00 (includes lunch meals, banquet meal, and a conference t-shirt) NOTE: REGISTRATION FEES ARE NON-REFUNDABLE No cash, credit cards, or purchase orders accepted.Checks, money orders, or drafts on U.S. currency will be accepted.Payment in full must accompany this form. Payable to:Georgia D.A.R.E. Officers Association. If you anticipate the purchase of additional meal tickets please indicate the number below.The cost per meal is $12.00 lunch, and $25.00 banquet.DO NOT send payment for these tickets with your registration form.You may pay for them at registration; however, you MUST include the number you wish to purchase to guarantee meals. Tuesday lunch:number of tickets___________ Wednesday lunch:number of tickets________ Thursday lunch:number of tickets_________ Thursday banquet: number of tickets: ________ Additional conference t-shirts will be available for purchase at the registration. Please send registration to:Georgia D.A.R.E. Training Center P.O. Box1192 Tunnel Hill, GA30755