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Terrorism Utilizing Weapons of Mass Destruction

February 17-19, 2002 • Clearwater, Florida
To register for the February 2002 terrorism seminars, print this page and submit your registration form with payment to S-2 Safety & Intelligence Institute by fax or mail:

S-2 Safety & Intelligence Institute, 1261 South Missouri Ave., Clearwater, Florida, 33756
Tel. (813) 227-8585 / (727) 461-0066 • Fax (727) 449-1269

Name:_____________________________________________________ Title:_______________________________

Organization Name:______________________________________________________________________________

Address:_______________________________________________________________________________________

City:____________________________________ State:__________________ Postal Code:___________________

Country:_________________________________________________

Telephone Number:____________________________________ Fax/Email:_________________________________

 

I understand that this is a restricted seminar. Accordingly, I hereby affirm that I am currently employed in a full-time security, law enforcement, or emergency management capacity.

I understand that I may be requested to provide proof of my employment* during the morning registration period.


Signature:________________________________________ Date:________________

*Florida state "D" or "G" license, official agency ID, military ID, or a business card and letter from employer.


REGISTRATION INFORMATION

____ Bomb Countermeasures Seminar Only (February 17-18,2002) ..........................$125.00 = _____________

____ Chemical and Biological Terrorism Seminar Only (February 19,2002) .................$250.00 = _____________

____ Both Seminars (February 17-19,2002) ...........................................................$325.00 = _____________

Membership Discount ....................................................................................... - $25.00 = _____________
(S-2 Members, ASIS Members, and Active Law Enforcement Only)

TOTAL ......................................................................................................................US$_____________

 

PAYMENT METHOD

____ Check enclosed ______ Bill us. P.O. Number:___________________________ (Approval Required)

___ VISA ___ Mastercard ___ AMEX / Card Number:_____________________________________ Exp.:___________

Name (as appears on card):__________________________________ Signature: ______________________________