Law Enforcement Membership Application

Please complete this form and hit submit. The next step will be completion of the Code of Ethics form.
Rank/Title*
Name*
First Last
Agency/Company*
Mailing Address (if different)
Mailing Address City State ZIP Code
County
Referred by*

Please enter name of individual that referred you or 'n/a'
Office Phone*
Cell Phone*
Direct Line
Fax*
Email*
Please share social media accounts for you and your agency. (Facebook, Twitter) or if none, enter N/A*
Administrative Assistant's Name*
Assistant's Email*
Local Association
Position*
Agency Type
Number of Sworn Personnel
Population Served
Your Purchasing Authority
Law Enforcement Membership
Name of Individual Completing Form
When you hit 'submit' the Code of Ethics page will be available. You must read and sign to complete your application. Applications are not deemed complete until we receive the membership application and Code of Ethics. Staff will then seek an endorsement.