Membership Application Type of Membership —Please choose an option—Associate MembershipActive MembershipActive Membership w/ Legal Defense Name Address Phone Personal Email Date of Birth Sex —Please choose an option—MaleFemale Employer How many years? Duty Title Division Employer Address Law Enforcement Credentials Please upload a copy of your Active Duty or Retired Law Enforcement Credentials with this application. Payment Method —Please choose an option—CheckCashBank Draft *$0.28 Monthly Bank Draft Fee Applicable Membership Dues —Please choose an option—Membership Dues Only ($4.25/mo)Membership Dues and Legal Defense ($25.85/mo) Enter Your Signature Clear
