Join Us

Membership Application

We would be glad to have you join us. The fee for Active & Non-Uniform members is $25.00. Retirees pay $15.00. Please fill in the following information and submit this application. Once the form is complete and submitted, you will be redirected to our Paypal page where you can submit the payment for membership.
A Paypal account is not required to make payment. You may use your credit or debit card.
"*" indicates required fields

If you prefer to not register online click here to print out the application and return it to us with your payment.
Name*
First Last
Email*

Address*
Street Address Address Line 2 City State ZIP Code

Home Phone
Cell Phone
Shield

Facility

Rank

Date of Appointment
MM slash DD slash YYYY

Beneficiary*
First Last
Agency

City

State

Federal
Are you Uniform or Non-Uniform?*

Uniform

Non-Uniform
Please check which committees you would like to serve on:*
Fundraising
Membership
Grievance
Mentoring
Legislative
Education
Web/Technology
Newsletter
I do not wish to serve on any committees at this time.
Are you retired?*

Yes

No
Retirement Date
MM slash DD slash YYYY

Is this a new membership or renewal?*

New

Renewal
Active/Non-Uniform Membership Fee

Price:

Retiree Membership Fee

Price:

Add additional $5.00 if you wish to donate toward Scholarship Fund*

Yes - $5.00 Scholarship Donation

No Donation
Subtotal
$0.00
How will you submit payment?*
select one

PayPal

CashApp
Paypal Fee
$0.00
Transaction Fee

Price:

Total

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