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Citizen’s Police Academy Alumni Association
Membership Registration
□ Adult Membership $20.00 □ Lifetime Membership $200.00
□ Student (12-hours) $5.00 □ Couple Lifetime Membership $300.00
□ Couple Membership $30.00 □ Senior Citizen’s Lifetime Membership $50.00
□ Senior Citizen’s Membership $5.00
Name: ______________________________________________ Class #: ______________
Address: __________________________________________________________________
__________________________________________________________________
Home Phone #: ____________________________ Work Phone #: ____________________
Email Address: _____________________________________________________________
□ I would like to receive Email reminders, special events and newsletters
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