Please complete the appropriate information fields:
* Name of Person Receiving Registration:
Title:
Agency:
* Address:
* City:
* State:
* Country:
* Zip/Postal Code:
Phone:
-
Fax:
-
* E-Mail:
* Name of Person Completing Online Payment:
* Affiliation (select one):
Local Adult Corrections
State Adult Corrections
Training Commissions/Academies
Community Based Programs
Military Correction
Juvenile Corrections
Federal Corrections
Higher Education
Health Care Delivery Trainers
Private Sector Training
International Community
* Type of Membership (select one):
New Member in USA - $50
Renewing Member in USA - $50
Library Member - $50
Full-Time Student w/ ID - $35
New Member not in USA - $50
Renewing Member not in USA - $50
Method of Payment:
Click "Pay Online" to purchase Online
To pay by check/money order/purchase order print this form and mail to the below address:
IACTP
8672 Forest Hill Dr
Baton Rouge, LA 70809-2227
Phone/Fax: 877-88 IACTP (877-884-2287) or (719) 738-9969
Email: iactp@correctionsmail.com
