311135 05/09/17 9`�v ��'"`� CITY OF CARMEL, INDIANA VENDOR: 00352848
ONE CIVIC SQUARE INTERNATL CONF OF POLICE CHAPLAIrWECK AMOUNT: $***`***500.00*
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CARMEL, INDIANA 46032 PO BOX 5590 CHECK NUMBER: 311135
'biTON DESTIN FL 32540 CHECK DATE: 05/09/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 05864 500.00 TRAINING SEMINARS
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International Conference of Police Chaplains
44th Annual Training Seminar —Norfolk, VA
July 10-14, 2017
PREREGISTRATION REQUIRED
EMAIL CONFIRMATION SENT UPON RECEIPT OF REGISTRATION
Last First Md
Name: �' Name: C�j��'� Initiai�WU
Email: i ,/,a,e )�d,L ��< <CQ Cell Phone`7-,�G
Street: �® �� City: /
Zip .�
Stat J� Country/ �jE l�d �7� Attending Spouse first name: dQtr`'�
�/ L Code:
Where are you lodging?C'/e� /_ yam/ ��Youth Attending?Yes No
�
Youth Registration & Medical Form MUST be received by 6/6/2017—NO WALK INS ACCEPTED
Banquet Selection(1 per attendee/spouse/guest—indicate a number. Example 1 Chicken, 1 Beef,etc.)
Beef.-_v Chicken: Kosher: Vegetarian: Gluten Free:
PAYMENT ; Register Now—Payment May Follow
OPTIONS•
D(US NOT seFunnd cash) *Lodging NOT included. Member Non-Member Fee Total
Basic/Enrichment/Liaison* $275.00 $415.00
• Personal/AgencyIncludes Monday
W10-
CheckNisa/ A01—Maxwell Institute Leadership* $500.00 ICPC Night Mixer and
MasterCard Members Only Banquet
A02—Breach Point/Pain Behind* $375.00 $560.00
• International
Attendees—Email Auxiliary:Spouse/Guest Fee* Includes Monday Mixer and Banquet @$90.00
for registration and * Medical Release Required by
fee requirements: Children(ages 5-17 only) 6/6/2017 @$75.00
If you have questions or Extra Banquet Tickets @$65.00
need assistance please REGISTRATION OPTIONS (use only one)
contact the office via: 1
•Email: icpc@icpc4cops.org
icpc@icpc4cops.org *Fax: 850-654-9742
850-654-9736 *Mail: ICPC I PO Box 55901 Destin,FL 32540-5590
Pages 11 and 12 are REQUIRED FOR REGISTRATION! TOTAL
OFFICE USE ONLY—Email Applicant ATS DB Payment Processed
Visa/MasterCard Payment Authorization
Chaplain Last Name: First:
Visa/MasterCard#: — — —
Exp.Date / Card Type: Agency Church Personal
Date
Cardholder Name/Signature:
Call for verbal authorization: —_) - TOTAL $
2017 ATS Norfolk,VA Page 11
Pages 11 and 12 ARE REQUIRED TO REGISTER!
LAST NAME FIRST NAME
Basic/Enrichment/Liaison Classes: Select only ONE class per time block.
8:30 to 10:00 10:15 to 11:45 1:15 to 2:45 3:00 to 4:30
Commi1TEE 1101—Intro to LE Chaplaincy 1102—Death Notification
MEETINGS ,04—Understanding the E14—Ministering to Officers
Mon
8:00 AM Chaplain's Roles in ICS OPENING SESSION of the Islamic Faith
7/10 E03`—The Police Chaplain& BEGINS 1:00 PM E21--Creating an Ethical
FIRST TEMIER Homeless Community Culture
ORIENTATION L01--Chaplain Program E29—Serve the City&
9200 AM Models 4 Community Policing
1103—Stress Management 1104—Ceremonies&Events B05--Confidentiality and 1110—Suicide
Legal Liability
E05—Debriefing for Chaplains E05—Debriefing for Chaplains E05—Debriefing for E19—Ancient Solutions
Tues Chaplains
7/11 28—Concems of Police E09—Family Homelessness E2&-Concems of Police E25—Succession is not
Survivors Survivors Retirement
1,04—American Red Cross 4—American Red Cross 1,04—American Red Cross L04—American Red Cross
—Part I of 4 —Part 2 of 4 —Part 3 of 4 —Part 4 of 4
B06—Ethics 1107—Responding to a Crisis B08—LE Family
E01--Chaplains Role in Mass E11—Police Chaplains
E08—Psychological First Aid Civil Disturbances Interviewing Witnesses
and Suspects MEMORIAL
Wed E22—Safe Passages:A SERVICE
7/12 E06—Teaching Emotional and Community Approach 3.00 PM
E20-21 st Century Chaplaincy Spiritual Survival in Law to Battling the Heroin
Enforcement Epidemic
E2"ut of the Frying Pan L05—Your Chaplain Did E10—Stalking and Digital
Into the Fire What? Violence
E12—Disaster Spiritual and 1109—Substance Abuse E07—Active Shooter
Emotional Care Presentation BUSINESS
E13—Post Care for OfficersAfter Using Deadly MEETING
E02—Females in Chaplaincy— E17—Cyber Crime
Thurs Force Love Them/Leave Them Presentation 3:00 PM
7/13 1,03--Policy and Legal E18—Civil Rights
Considerations E16—Chaplain Self Care Presentation BANQT
1,06—Federal Liaison Program L02—Leading and Chaplain 6:30 PM
Management
1111—Officer Death and Injury 1112—Sensitivity and Diversity
Advanced Classes:
Els—The Heroin Crisis E26—Ambassador Program
in America for Chaplaincy (Tuesday-Thursday)
Fri E23—Reshaping Enforcement Stress Select ONLY ONE
E23—Reshaping the Narrative and Bumout—Part 2 of 2
7/14
E27—Law Enforcement Stress E29—Serve the City& A01—Maxwell Institute Leadership Training
and Bumout Part I of 2 Community Policing (Limited to 40 ICPC Members)
L07—Current Events in L08—Investigators A02—Breach Point Seminar(Day 1)
Chaplaincy Management Understanding Islam Pain Behind the Badge(Day 2/3)
Ftunity
IASOlUTIONS 2017 Exclusive Scholarship MOTOROIASOttmONS
Application Deadline—4/30/2017
olutions Foundation provided a generous grant which allows ICPC to offer our members an oppor-
ply for 16 scholarships to attend the 2017 ATS training.
Members may download an application from our website: www.icpc4cops.org—Members Only Section—
ATS Folder.
2017 ATS Norfolk,VA Page 12