ONLINE Membership application & RENEWAL Form

 Retired United States Park Police Association

I hereby make application for membership in The Retired United States Park Police Association, Inc. 

 in accordance with its Bylaws and agree to be bound by them.

Information provided will be used to compile The RUSPPA Membership Directory.

Please complete all items and be precise.                          Questions regarding this form may be addressed to CShane@usparkpolice.org

First Name    MI
Last Name DOB
Spouse Name DOB
Street Address Suite/Appt No
City State Zip + 4
Work Phone Home Cell
E-mail Address
 

Current Status

Retired USPP

(Date Retired)

(Title)

Active USPP

(Title)

(Date Hired)

Other

(List Other)

 

Include my listing in The RUSPPA Membership Directory

Yes

No

All applications are reviewed and approved by the Board of Directors

 

Applying For - (Select Only One Membership Type)

New Active Membership - ($25.00) Retired USPP Only (Spouse Included)

New Associate Membership - ($25.00) Active USPP (Spouse Included)

 

New Associate Membership -  ($25.00) Other (Other Law Enforcement Agencies Officers, Employees and Retirees, etc.)  NOTE: Application for this type of membership must be accompanied by a recommendation of an active member.

Renewal Membership ($20.00)

(Membership Number)

Membership Application Fee (Select only One Fee)

1 New Membership @ $25.00  

1 Renewal Membership @ $20.00 

 

Your Payment Method (Select Only One Payment Method)

Personal Check Enclosed

Cashier's Check or Money Order Enclosed

**All applications must be accompanied with this form.

Membership Applications are not processed until appropriate fee is submitted**

 

AFTER SUBMITTING, PRINT THIS FORM AND MAIL TO

RUSPPA, 1193 West Shore Drive, Brunswick, GA 31523

 

 
Applications received between January 1 - September 30, shall apply to 
membership dues for current calendar year only.  Application fees paid between
October 1 - December 31 shall applied to membership dues for following calendar year.