MILWAUKEE  RETIRED POLICE ASSOCIATION

   2010 MEMBERSHIP APPLICATION

RENEWABLE  EVERY JANUARY 1st

         NEW: _____    RENEWAL:_____ DUES: $ 5.00         DONATION  $ ________

Last Name : ______________________________________ First: _____________________

Address:__________________________________________________________Apt.#____                                                                                    

City:_______________________  State:  _____     Zip Code:  _________

DOB___________ __________________________  Age ______

Phone #______________________Listed____Unlisted_____

E-Mail (secure) ________________________List on Website_________________________

Spouse Name:__________Deceased______Anniversary Date:__________________________

I Completed 25 years of  service with The Milwaukee P.D.

In Year__________Retired In Year____________

Comments: ___________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

SNOWBIRDS: List winter address_________________________________________________________________

And what months you’ll be there_________________________________________________________________

 Print this application out and mail it along with your dues to the below address:
Mail To :
Milwaukee Retired Police Association 
P.O.Box 340877

Milwaukee WI 53234-0877

Click here to download and print Application