Page 41 - TPA Journal January February 2023
P. 41

Become A Member of TPA!






                                               Application for Membership
                                          TEXAS POLICE ASSOCIATION







         Active (Law Enforcement) - $30.00                Agency Affiliate - $25.00 per Officer



         Name                                                       Date of Birth



         Agency/Company                                            Title



         Mailing Address




         City                                              State             Zip



         Contact Phone Number




         E-mail Address



         Name of Beneficiary
                           Active Membership Includes $7,500.00 IN THE LINE OF DUTY & Accidential Death Benefit

         I certify that the beneficiary named above is correct according to my wishes.




         Signature                                                   Date






         Mail Application and Dues to:     Texas Police Associati on, P.O. Box 4247, Austin, Texas 78765-4247






        Jan. - Feb. 2023         www.texaspoliceassociation.com • (512) 458-3140                         37
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