DPSOA CONFERENCE 2007  ~  AMARILLO, TX

ASSOCIATE MEMBERSHIP APPLICATION
"Support Your DPSOA Family"
 

Since the Texas Department of Public Safety was established, 82 DPS Officers have been lost in the line of duty. 2007 marks 34 years that the Texas Department of Public Safety Officers Association, a non-profit organization, has been dedicated to the aiding of families of DPS Officers who have been killed in the line of duty.  The Death Benefit Fund, a special fund established by DPSOA, lends financial support to the family left behind when tragedy strikes.  In the years since it was founded, the benefit has lent vital support in times of need.  The DPSOA invites you to join our cause.  Support the Death Benefit Fund by taking advantage of a unique opportunity to become a DPSOA Associate Member.  Here's the opportunity to join the ranks of an Association that proudly claims amongst its members State Troopers, Criminal Law Enforcement Officers, Narcotics Officers, Texas Rangers, Communications Personnel and other branches of the state's top law enforcement.

NAME:  

____________________________________________________________

      

  

COMPANY NAME  

____________________________________________________________

  

  

ADDRESS   

STREET _____________________________________________________ 

 

CITY_______________________________ STATE _____ ZIP_________

 

  

HOME PH  

____________________________________________________________

 

 

BUSINESS PH.

____________________________________________________________

  

 

 

Associate Membership Desired (Please check one)

 

CORPORATE PERPETUAL

________

$ 1,000

 

CORPORATE 10 YEARS

________

$   700

 

INDIVIDUAL LIFETIME 

________

$   500

 

INDIVIDUAL 5 YEAR

________

$   200

 

ANNUAL

________

$   100

 

Corporate or Individual Lifetime             Individual 5 Years or Annual

Bumper Sticker                                             Bumper Sticker

Windshield Decal                                          Windshield Decal

DPSOA Lapel Pin                                         DPSOA Lapel Pin

Membership Card                                         Membership Card

Bronze Belt Buckle                                       Bronze Belt Buckle

Magazine                                                       Magazine

Wall Plaque

 

 

Signature of Applicant:_________________________________________________________

Date: ______________  Sold By: ________________________________________________

Amount: ___________________   Check # ________________________________________

***PLEASE NOTE THAT THE  "BOOSTER MEMBERSHIP"  HAS BEEN ELIMINATED.

MAIL TO:  2007 DPSOA CONFERENCE
Wayne Williams
4402 Derrick Place
 Amarillo, TX 79121