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Region 10 New Jersey would like to welcome any and all visiting members of the International Police Association.

In order to assist you properly, please fill out this entire form and send it to us via this web site. It will be received by the New Jersey Reception Officer and he will get back to you to discuss your visit.
 
If you are NOT a member of the International Police Association, DO NOT fill out this form and instead contact the Community Affairs Officer of the village, town, and city Police Department where you will be visiting.
 
 

Tell us how to get in touch with you:    All fields with an * are required.

First Name:*

Last Name:*

IPA Membership No.*

E-mail:*

Region:*

Country:*

Police Rank:

Police Agency:

IPA Office:

Home Address:

Street: One

Two:

City:

State/Country:

Telephone:

  Retired: Yes  No     Age:


Persons Traveling with you:


Date of Arrival to New Jersey:
 

Date of Departure from New Jersey:
 

Hotel Name:

Hotel Phone Number:

Hotel Address:

Street: 

City:

State: Postal Code:

Please contact me as soon as possible regarding this matter.

Enter your comments in the space provided below:


 

Please type the code shown in the image:      
 
 
 
Holiday Inn is the Official Hotel of Region 10- New Jersey
All IPA Members need to show their IPA Cards and the Hotel will recognize it.
Members will get the Government rate which is approximately $ 114.00.
Call the Hotel directly, at the number indicated on the card Below.

 

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