National Police Week 2025 Registration

Each survivor requesting reimbursement from Iowa C.O.P.S. for attending National Police week must read and acknowledge the Iowa Chapter of Concerns of Police Survivors National Police Week Travel Assistance Contract. Parents and guardians are required to ensure that children under their supervision attend the required courses outlined. Failure to follow the above outlined requirements will forfeit your eligibility for reimbursement and in some cases require you to reimburse Iowa C.O.P.S. for your expenses and will possibly exclude you from future reimbursement in attending National Police Week and/or other C.O.P.S. programs. Iowa C.O.P.S. reserves the right to approve or deny travel reimbursements and this application does not guarantee payment for reimbursement. Applicants will be notified of reimbursement before travel.

Applicant Information
Name*
First Middle Last
If Minor Child Please Check Box
- CHECK BOX
Minor Child Birth Date
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Fallen Officer
Your Relationship to the Fallen Officer*
If Other Please List Relationship
Fallen Officer's Name*
First Last
Fallen Officer's Agency*
End of Watch Date*
What Year Was Your Officer's Name Added to The National Wall*
Is This Your First Year Attending NPW*
If NO Please List Years You Received Financial Assistance From IOWA C.O.P.S.
T-Shirt Information
Adult T-Shirt Size
Child T-Shirt Size
Travel
Travel Expenses That You Are Requesting*
- Air Fare/ Luggage Fees
- Hotel
- Fuel Receipts
Signature*
By typing your name, you confirm that you have read and agree to all terms and conditions contained within this contract, including the understanding that reimbursement for travel expenses to NPW is at the discretion of the IOWA C.O.P.S. board.
First Middle Last

Applicant Information

Fallen Officer

T-Shirt Information

Travel