JOIN US for our 47th Annual POCI Convention ~ Gettysburg, PA ~ July 16-21, 2019
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JOIN US for our 47th Annual POCI Convention ~ Gettysburg, PA ~ July 16-21, 2019

Online ConventionRegistration Form
2019 POCI Annual Convention ~ Gettysburg, PA ~ July 16 - 21, 2019
Membership Type:
(select Membership Type you wish to order.)
POCI User Account Information
POCI Username:
(max. 16 characters)
POCI Password:
(max. 16 characters)
POCI Re-Type Password:
(max. 16 characters)
Password Retrieval Question:
Password Retrieval Answer:
Registrant Information
Member's First Name:
Member's Last Name:
Badge Names
 
Spouse's Badge Name:
First Name Last Name
 
Child 1 (under 18)
Child 2 (under 18)
Child 3 (under 18)
Child 4 (under 18)
First Name Last Name
 
Child 1 (over 18)
Child 2 (over 18)
Child 3 (over 18)
Child 4 (over 18)
First Name Last Name
Number of Children:
Address 1:
Address 2:
City:
State or Province:
ZIP or Postal Code:
Country:
EMail:
Home Phone:
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Convention Registration
Convention Fee
$65.00
Choose: 		Convention Registration Fee - 2019 Convention Registration Fee - please note, this fee is non-refundable
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Annual Convention
2019 POCI Annual Convention ~ Gettysburg, PA ~ July 16 - 21, 2019
2019 POCI Annual Convention ~ Gettysburg, PA ~ July 16 - 21, 2019

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