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MEMBERSHIP APPLICATION (PLEASE CHECK WHICH MEMBERSHIP YOU PREFER) MEMBERSHIP : Any Administrative Personnel to a Chief Law Enforcement Official within the State of New Hampshire shall be eligible for membership in one of the following designated categories:( ) ACTIVE MEMBER: Any Administrative Personnel to a Chief Law Enforcement Official within the State of New Hampshire who joins the Association in years subsequent to 1993. 2 meetings per yr attendance required. (See annual dues fee below)( ) EMAIL/INTERNET ACCESS ONLY MEMBER: Same requirements as an Active Member listed above; however, member is unable to meet the 2 meetings per yr attendance required. (See annual dues fee below)( )ASSOCIATE MEMBER: Any retired secretary to a Chief Law Enforcement Official within the State of New Hampshire not already a member in good standing and any Administrative Personnel in a Law Enforcement Community (i.e.; Detective, Prosecutorial, etc.) may become an Associate Member by a two-thirds vote of attending members. Associate members have no voting privileges. NAME: ____________________________________________________________________________ First Middle Initial Last BUSINESS ADDRESS: _______________________________________________________________ MAILING ADDRESS: (if different) ______________________________________________________ LAW ENFORCEMENT AGENCY: _______________________________________________________ CHIEF LAW ENFORCEMENT OFFICIAL: _________________________________________________ NAME TITLE SIGNATURE OF CHIEF LAW ENFORCEMENT OFFICIAL: ___________________________________ TELEPHONE NUMBER: ________________________ FAX NUMBER: __________________________ EMAIL (HOME): ______________________________ EMAIL (WORK): __________________________ Mail your completed application to: Rebecca Warburton, President Rochester Police Department 23 Wakefield Street Rochester, NH 03867 For Membership Committee Only: This application meets the NHCOPSA requirements and is eligible to become a: ( ) Full Active Member: $50.00 per year for a full access membership. A full membership requires the attendance of at least two of the four meetings held each year. At the end of the membership year, if the member does not make the minimum of two meetings, the membership will convert to an e-mail/internet only membership and the member will be charged the additional $25.00. ( ) Email/Internet Only Member: $75 per year for email and on-line only access. Those who choose this membership do have the option to attend meetings. If an email/internet only member attends two meetings during the year, the membership will convert to a full membership. The second meeting they attend for that year will be "free" using the extra $25 for email membership to cover the cost of the 2nd required meeting for a full membership that would cost $50 for the year. ( ) Associate Member ($25.00 Annual Dues) *********************************************************************************************************************************** Signature of Membership Committee Member ______________________________________ Date of Membership _____________________ cc: NHCOPSA Treasurer and Executive Board Membership Committee Training Committee |
