subject_line
National Black State Troopers Coalition Membership Application
Membership Type:
*
Individual - Any State Trooper who is an active or retired member of a State Police, State Patrol, State Highway Patrol or State Department of Public Safety Agency and in good standing with their State Chapter, if one exist. Individual members must support the interest of furthering the goals and objectives of the NBSTC. * Return with $25.00 membership fee and copy of credentials
Associate - All individuals of any law enforcement agency who do not meet the qualifications for chapter membership(s) and who support the interest of furthering the goals and objectives of the NBSTC. An Associate Member may be elected to any office with the exception of the offices of President and Vice President. *Return with $25.00 membership fee and copy of driver’s license
Business Associate - All civilian business community supporters interested in furthering the goals and objectives of the NBSTC. * Return with $75.00 membership fee and Business card.
Name:
*
Rank:
*
Address:
*
Date of Birth
*
+
Home Phone:
Cell Phone:
Preferred Email Address
*
Agency:
Job Description:
Instructor Certifications check here.
*
Instructor Certified
Explain Instructor Certificate:
Work Address:
*
Signature of applicant:
*
clear
National Black State Troopers Annual Dues *
*
Individual Membership $25
Associate Membership $25
Associate Business Membership $75
An Online Convenience fee of .87 cents will be added to the Individual and associate members fees. And an Online Convenience fee of 1.99 cents will be added to the associate business member fee upon final transaction.
Current Total:
$0.00
Calculate
State Chapter Name If one Exist:
Date:
*
+
Powered by
Report abuse