GUARDIANS ASSOCIATION 2023 MEMBERSHIP APPLICATION

GUARDIANS ASSOCIATION

2023 Membership Application
GUARDIANS ASSOCIATION

NEW YORK CITY POLICE DEPARTMENT

P.O. BOX 87

PECK SLIP STATION

NEW YORK, NEW YORK 10272-0087
Dear Applicant,

Thank you for your interest in joining the Guardians Association of the New York City Police Department. Our Membership Committee would appreciate you furnishing the following information. [Please Print all Information]:
Date

MonthDayYear
Date
First Name
M.I.
Last Name
Mailing Address
Apt#
City
State
Zip Code
Home /Cell Tel#
Please enter a valid phone number.
Please note: "nypd.org" emails have experienced "bouncing" or effects of firewalls installed by NYPD. It is recommended that you provide a different email to insure proper delivery of all membership-related information
Preferred Email Address
example@example.com
Rank/Title
Shield #
Tax#
Command
Command Phone Number
Please enter a valid phone number.
Date Appointed

MonthDayYear
Date
Date Retired

MonthDayYear
Date
Interested in joining a committee? Insert Yes / No
Program
Community
Political
Fundraising
Media/Marketing
Scholarship
Social
Budget / Finance
Sick / Welfare
Nomination Election
Constitution
Purpose of this application:

RenewalNew MemberChange of Information
REFERRED BY
Annual Dues cover the period of the calendar year January to December. Return application to your Delegate, Trustee. Board Member or by mail to our mailing address listed above.

DUES RATE CHART (Per Year)

Uniformed Members $30

Associate Member (Civilian / Non-NYPD) $20

Retired $20

Lifetime Membership (Retired Only) $225
Membership Category

Uniformed MemberRetiredAssociate (Civilian / Non-NYPD)Lifetime Membership
Amount Enclosed
Check / Money Order#
NYCAPS-ESS
Should be Empty: