6 22 2012 fundraiser registration 0 by p8GrX5P

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									                     MISSISSIPPI TACTICAL OFFICERS’ ASSOCIATION
                           1-DAY SWAT COMPETITION/BENEFIT
             PROCEEDS WILL GO TO RETIRED MHP TROOPER BUDDY BLACKWELL
                                 JUNE 22, 2012 8AM-5PM
                 MS LAW ENFORCEMENT OFFICERS’ TRAINING ACADEMY
                                      PEARL, MS
      $100.00 ENTRY FEE COVERS YOUR ENTIRE MTOA MEMBER TEAM FOR TEAM
                                ENTRY/SNIPER EVENTS
             INDIVIDUAL FIREARMS MATCH FEES WILL BE COLLECTED AT EVENT.


AGENCY NAME_________________________________________________________________

ADRESS________________________________________________________________________

CONTACT PERSON______________________________________________________________

CONTACT PHONE_______________________________

ROSTER OF PERSONNEL ATTENDING:

1._______________________________________2._____________________________________

3._______________________________________4._____________________________________

5._______________________________________6._____________________________________

7._______________________________________8._____________________________________

9.______________________________________10._____________________________________

11._____________________________________12._____________________________________

Add extra sheet for names as needed….

METHOD OF PAYMENT (SELECT ONE)

______INVOICE MY AGENCY (P.O. #__________________________________)

______PAYMENT OF CHECK OR CASH AT EVENT

______PAYMENT ENCLOSED WITH REGISTRATION


RETURN THIS REGISTRATION FORM TO SEC/TREASURER RANDY RUFFIN BY
6/10/2012 AT THE ADDRESS BELOW:

RANDY RUFFIN
4 NORTHWOOD PLACE
CLINTON, MS 39056

								
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