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* 1. What is your first and last name?

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* 2. What Police Department do you work for?

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* 3. How many Sworn Full-Time Officers Work for your Department?

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* 4. What Email Address can we contact you at?

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* 5. What Phone Number can we contact you at?

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* 6. I agree to submit my $25.00 payment for 2019 Dues to the Association
through Paypal here: Pay Dues Here or by mailing my payment to the

Association at the address listed on the website. 
I understand that my application will not be processed until my payment is
received.

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