NCPOA APPLICATION FOR MEMBERSHIP
Please complete application and return it with a check for membership to : NCPOA
PO Box 983
Sloughhouse, Ca. 95683
Home Address :________________________________________________________________
Telephone: Home: ( )________________________ Business ( )__________________
E Mail Address________________________________________________________________
Employed By (Law Enforcement Agency): ___________________________________________
Please submit a copy of your department issued active or retired identification card.
Position, Rank or Title:___________________________________________________________
If retired check: ___ Agency retired from: _________________________________________
Current members will be given credit for sponsoring a new member.
Associate only: Justification for sponsorship ________________________________________
Signature: ___________________________________________ Date:____________________
For Non-Law Enforcement Applications Only: The NCPOA has traditionally been for active and retired law enforcement and public safety members. However, non-law enforcement applications have been accepted from individuals that have distinguished themselves for being supporters of law enforcement.
ALL DUES ARE JULY 1ST to JUNE 30TH EACH YEAR
Dues: Active Members-$25.00 Annually ; Associate Members-$25.00 Annually ;
Life Membership $300.00 or over age 60 and 5 years membership in good standing $200
Name tags are available for $8.00. Life Member badges are complimentary.