California State Coroners' Association
REGISTRATION FORM
Annual Fall Training Symposium
Sunday, September 18 through Friday, September 23, 2022
Monterey Tides, 2600 Sand Dunes Dr. Monterey, CA.

* = required field

First:*  Last :*  Middle: 

Office Address:*  City:*        P.O.S.T. ID#:  

Zip:*   County:*   Phone:*  

E-Mail Address:*      Member: (With Dues Paid):* Yes   No

Are You A Public Safety Member:*   Yes   No Retired?   Yes   No
(Some classes may not be available to non-public safety members)

NOTE - P.O.S.T. CREDIT IS GIVEN FOR REGISTRATION FEE 32 HOUR+BLOCK ONLY

REGISTRATION
Registration Fees
Before 9/1/22 After 9/1/22  
Members $350 $375  
Non-Members $375 $425  
Registration Fee: 
Your registration fee includes two complimentary meals shown below. If you are bringing a guest who is not paying a registration fee, you may purchase their meals separately. All guest meals must be purchased in advance.
Meals - Indicate Attendance Below*
Monday Vendor Cocktails $ Free
Tuesday Luncheon # X $38/meal
Banquet # X $66/meal
Tuesday Luncheon $ Free
Wednesday Banquet $ Free
Purchase Meals for Your Guests Here
Tuesday Luncheon # of Guests X $38/meal
Wednesday Banquet # of Guests X $66/meal
Meal Total  

Banquet Menu

Registration complimentary meal choice
(Select One)
Write the number of guest meals selected in the box below
(Purchased Banquet Meals)
  New York Strip Steak    New York Strip Steak
  Chile Seared Chicken Breast    Chile Seared Chicken Breast
  Dijon Panko Crusted Salmon    Dijon Panko Crusted Salmon
  Vegan Option (Upon Request)    Vegan Option (Upon Request)
 
*I will attend the Vendor Cocktail Reception on Monday evening  Yes       No
*I will attend the Luncheon on Tuesday  Yes       No
*I will attend the Banquet on Wednesday Evening  Yes       No
Total Symposium Fees   
Pay to CSCA Executive Secretary

CALIFORNIA STATE CORONERS' ASSOCIATION REGISTRATION CANCELATION POLICY
Cancel your Registration by 9/12/22 and you will be reimbursed.
Cancel your Registration after 9/12/22 and you will not be reimbursed.
All refunds will be subject to a $25.00 Administrative fee.

MAKE CHECKS PAYABLE TO CSCA.
MASTER CARD & VISA WILL BE ACCEPTED FOR PAYMENT FROM SUNDAY, SEPT 18th TO FRIDAY, SEPT 23rd.
MAIL CHECK AND FORM TO: Robert Foucrault, CSCA EXECUTIVE SECRETARY, 211 Bradbury Lane, Redwood City, CA 94061
PLEASE USE SEPARATE FORM FOR EACH REGISTRANT (Photocopy ok)