Cedar City FOP Lodge 83

Fraternal Order of Police
Cedar City Lodge #83
P.O. Box 2275
Lebanon, TN 37088
Email: cedarcityfop@gmail.com
Greetings:
We're glad to hear you're interested in membership. We'd love to have you join us in becoming a member of the Cedar City FOP Lodge. The Fraternal Order of Police is the world's largest organization of sworn law enforcement officers. From its humble beginning in 1915 initiated by 2 patrol officers in Pittsburg, it has now grown to more than 373,000 members in more than 2,200 lodges nationwide. The Tennessee State Lodge was organized in 1955. The State lodge has over 70 local lodges representing roughly 10,000 members.
We've attached a membership application, legal aid application and payroll deduction form. If you decide to join us, your membership will go into effect as soon as we get the application(s) to the state lodge with your dues. Your initial per capita and legal aid dues will be as follows. The payroll deduction(s) will cover you for the subsequent years so you won't have to write any more checks. Let us know if you have any questions.
Please make your check payable to:
Cedar City FOP - $264.00 for membership with legal aid
Or
Cedar City FOP - $126.00 for membership only (no legal aid)
**The initial membership / legal aid fees can also be paid electronically if preferred.

Tennessee State Lodge FRATERNAL ORDER OF POLICE Membership Application
Name:
Email:
example@example.com
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Phone Number:
Format: (000) 000-0000.
DOB:

MonthDayYear
Date
Zip
Employer:
Date hired:

MonthDayYear
Date
Rank
I, certify that I meet the membership requirements for the Fraternal Order of Police as set forth in their national and state Constitution and By-laws. I understand that providing any false information will be grounds for expulsion from the Fraternal Order of Police Lodge.
Signature
Date

MonthDayYear
Date
THIS SECTION TO BE COMPLETED BY LOCAL LODGE OFFICERS
I. Brent Willett
Secretary of FOP Lodge 83
Signature
Date

MonthDayYear
Date
I. Grant Cothron
President of FOP Lodge 83
Signature
Date

MonthDayYear
Date
Attention Lodge Sowetarian: Upon acceptance of members into your lodges, you are required to submit this form to the State Lodge along with your Losses and Gains in Membership form. Members listed on the Losses and Gains Come will not be accepted unless accompanied by this form.
Date received in State Lodge:
Revised 08/01/1022. All previous forms are considered obsolete.

Application/Enrollment
Tennessee State Lodge Legal Aid Plan
$125.00 Annual Fee Enclosed
Send a copy of the complete plan document
Name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone:
Format: (000) 000-0000.
Work Phone:
Format: (000) 000-0000.
Lodge Name and Number:
Social Security Number:
Employer/Agency:
I hereby apply for enrollment in the Tennessee State Lodge Legal Aid Plan. I agree to abide by all of the terms and conditions thereof. I understand that my coverage will not be effective until the receipt of my payment to the Plan and acceptance by the Legal Aid Committee of the Tennessee State Lodge Fraternal Order of Police. To my knowledge I am not presently named in any suits, actions, or proceedings, not under investigation for a duty related incident except for the following: (use additional paper and attach, if needed)
Signature
Date

MonthDayYear
Date

Fraternal Order of Police
Cedar City Lodge #83
P.O. Box 2275
Lebanon, TN 37088
Email: cedarcityfop@gmail.com
I authorize the City of Lebanon Payroll Department to deduct my membership and / or legal aid dues for the Fraternal Order of Police Lodge #83 from my paycheck. I understand that the deduction will occur on the 1st and 2nd pay periods of each month as indicated below by a check mark. The deduction(s) will begin on the pay date scheduled for ____/____/____.
Employee Name:
Employee Signature:
Date:

MonthDayYear
Date
Should be Empty:

Fraternal Order of Police