Attendee Information:
Name: ______________________________________________________________________________________________________
Organization: ______________________________________________________________________________________________
Address: ___________________________________________________________________________________________________
City: ______________________________________________ State: __________________ Zip: ____________________
Phone: __________________________________ Email: ________________________________________________________
Method of Payment:
(please select one)
*Please note: A convenience fee of 3% will be added by the card processing company to all credit card transactions. No part
of this fee goes to the National Fraternal Order of Police.
Check Amex Discover Mastercard Visa
Card Type: Debit Credit
Name on Card: ____________________________________________________________________________________________
Credit Card #: _____________________________________________________________________________________________
Exp. Date: ___________________________________ Security Code: __________________________________________
Billing Address: ___________________________________________________________________________________________
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Total Enclosed: $ __________________________________________________________________________________________
Send Registrations To:
(Registrations can be sent in by mail or email. Registration confirmation will be emailed upon receipt of this form and payment.)
National Fraternal Order of Police
Attention: Stephanie Simpson
701 Marriott Drive, Nashville, TN 37214
Phone: 800-451-2711 | Email: ssimpson@fop.net
Wellness Professionals Forum has been approved by National Board of Certified Counselors for NBCC credit.
Sessions approved for NBCC credit are clearly identified. National Fraternal Order of Police is solely responsible
for all aspects of the program. NBCC Approval No. SP-4459.
Date: February 18, 2024
Time: 8:00 a.m. – 5:00 p.m.
Location: Sheraton Music City
777 McGavock Pike, Nashville, TN 37214 | Phone: 615-885-2200
Registration Fee: $165 per person (Professionals Forum only)
$125 per person (If also registering for the Wellness Summit)
Registration Deadline: February 1, 2024.
Select One: Professionals Forum only Professionals Forum & Wellness Summit
*Please note: This form and fee are for the Professionals Forum only. A separate registration form must be completed, and
registration fee paid for the Wellness Summit.
2024 Wellness Professionals
Forum Registration Form
