NATIONAL LATINO PEACE OFFICERS ASSOCIATION -

SAN GABRIEL VALLEY CHAPTER

Membership Application

 

 Regular Membership:  ($60.00)* available to all peace officers actively employed or retired from any professional position within the criminal justice system and who supports the objectives of the National Latino Peace Officers Association.

Associate Membership:  ($60.00*) available to all non-sworn persons who identify with and support the objectives of the National Latino Peace Officers Association.

 

Name  __________________________________________________________________

Address  ________________________________________________________________

City  __________________________________  State ________  Zip Code _______________

Home Phone  __________________________   Pg Number  _______  _____ _____________

Agency  ____________________________________       _____________________________

Position/Title   _______________________________________________________________

Work Phone  __________________________  Cell Number ____________________________

E-mail _____________________________________  Fax No ___________________________ 

(Please check one:)

Regular Membership_______     Associate Membership ___________

 Mail your application form to:  National Latino Peace Officers Association

-San Gabriel Valley Chapter;   Post Office Box 2422;   Irwindale CA 91706.  And specify your method of payment:   Check enclosed ________ or monthly checking/saving account payment________.

 

NOTE:  Payments may be made at $5.00 per month with an automated payment plan from your checking/savings account.  Notify your bank to route your payments to #32227523 2 (CHP Credit Union) to the Chapter account #0000 503076.  B of A and Indy Mac OK with this.  Wells Fargo could not do it!  If you have an account with the CHP Credit Union you may call them to set up your automatic payment plan (909-599-9329).    NOTE:  APPLICATIONS MUST BE SUBMITTED.