Online Membership Form Membership Form Membership Type(Required) New Member Member (Law Enforcement) $40 Associate Member (Not Law Enforcement) $40 Renewal Retired (Retired Law Enforcement Only) $25 *New Associate Member Sponsor Name(Required)Name(Required) First Last Birthday(Required) MM slash DD slash YYYY Home Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Cell Phone(Required)Email(Required) Consent(Required) By providing your phone number, you agree to receive text messages from the Polish American Police Association. Message & data rates may apply. Message frequency varies. Reply STOP to opt-out, reply HELP for help. Privacy PolicyDepartment & Unit of AssignmentStarRankWork PhoneDepartment Retired From & Date RetiredWindshield Decals & StickersPlease indicate how many windshield decals or stickers you would like. Requests of more than two will require an additional fee of $2.00 each.Windshield DecalsPlease enter a number from 0 to 20.StickersPlease enter a number from 0 to 20.Completed Applications & Membership Payment Polish American Police Association, P.O. Box 31095, Chicago, IL 60631 or Email: [email protected] Payment options: Cash, Check, Zelle: [email protected] Venmo: @PolishAmericanPolice Section BreakPhoneThis field is for validation purposes and should be left unchanged.
