Replacement ID Card Application - Formulaire de demande de carte d'idenitié d'identification de retraite

Retirement Credentials ID Card Request Form

Canadian Military Police Association
Important Notice
Replacement ID Cards are $10 payable at the MP Kitshop. Don't forget to apply your CMPA Membership Discount Code found on the back of your CMPA Membership Card for a 15% discount. Your request will not be processed until your payment has been made and we are automatically informed of all payments. Please note that Retirement Credentials are only available to members in good standing of the CMPA. Please refer to CMPA By-law 6 for more information. By-Law 6
WARNING: Please be very careful when filling out this form. Your ID Card will be printed using the spelling you provide. You will be responsible for any replacement costs if a replacement ID Card is required due to a spelling mistake on this form.
Identification
Name *

First Name Middle Name Last Name
Service Number *
IF you do not have a SN, enter XXX. DO NOT enter your SIN.
MP Badge Number *
Date became a MP *

Day Month Year
Date retired or released as a MP *

Day Month Year
Email
example@example.com
Upload a head and shoulder's photograph. For best results take against a plain light coloured background. Acceptable types are TIFF, PNG, BMP,JPEG or GIF image. NOT PDF.

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ID Card Photo
Cancel of
Certification
By clicking yes, you are certifying that the following statements are true.
CMPA Retirement Credentials are only available to members in good standing of the CMPA *

Yes, I am a fully paid up CMPA member. No, I am not a CMPA Member.
What is your CMPA Membership Number *
(From the front of your CMPA Membership Card)
Mailing Address

Your ID Card will be mailed to the address you provided when purchasing your replacement ID Card. Please ensure that you have provided an address that you receive mail delivered by Canada Post.
Comments
Please verify that you are human *
Should be Empty:

Retirement Credentials ID Card Request Form

Important Notice

Identification

Certification

Mailing Address