AURORA POLICE RETIRED OFFICERS ASSOCIATION, INC.

APPLICATION FOR MEMBERSHIP

Membership type being applied for:             Active            Associate

Applicant Name:	     
 
If applying as a widow/er, your spouse's name:	     
 
Address:	     
	     
	(Street address, City, State, Zip)

Telephone   Landline:      	Mobile/text:      

Email:      

Your (or your spouse’s) date of hire or service years at APD:      

APD Academy class number:         Date of separation:       
 
Type of separation:    retired    medical    resigned    other:      

Current/previous rank/position:        

Associate applicant: Describe your other/previous/elsewhere service or qualifications:

     

Pro-rated Dues Payment Schedule for NEW applicants, if you first join in:
Jan.     Feb.     Mar.     Apr.     May     June     July     Aug.     Sept.     Oct.     Nov.     Dec.
$60     $55      $50       $45      $40       $35      $30      $25       $20      $15      $10        $ 5

Dues Paid:  $       Date paid:            Check   other:      

  Please check if paying through PayPal to treasurer@aproa.net (easy link at APROA.net)

	PayPal dues were sent from email:  same as above   or:      

Arrange any other payment method with the treasurer via email, at treasurer@aproa.net

scan and email this application to secretary@aproa.net, or mail printed application to: 
APROA, P.O. Box 473421, Aurora, CO 80047-3421
(Please make check payable to APROA)

Office use only:  Board member receiving application: ____________  Dues verified: ___________
Notes: ___________________________________________________________________________