Page 59 - TPA Journal July August 2018
P. 59



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






July/August 2018 www.texaspoliceassociation.com • 866-997-8282 55
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