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NPOAA/NPSOAA
National Police and Security Officers'
Association of America
National Headquarters
150 Maple Avenue #224
South Plainfield, New Jersey 07080-0663
Membership Application
Active Membership $35.00. Enrollment Covers 12 Months and Includes:
*NPSOAA Presentation Folder
*NPSOAA Membership Card
*NPSOAA Membership Certificate
*1 Copy of "Hell Ranch"
*Discounted Insurance Through Liberty Mutual Insurance Co.
*Subscription to The National Police and Security Review or The Focus
Since the creation and inception of the NPSOAA and the absorbing of Former NPOAA Members, the previously offered NPOAA Benefit
of Accidental Death and Dismemberment Insurance was terminated. As a Membership Bonus, the NPSOAA instituted a Special Membership
Benefit to Save You $327.96 on your Personal, Home and Auto Insurance (including 24-Hour Emergency Roadside Assistance) through
the Liberty Mutual Insurance Company. (Group#Client 4621).
Name:__________________________________________Title:_________________
Address:_____________________________________________________________
City:________________________________State:________ Zip: _______
Employment:__________________________________________________________
Date of Birth: ______ / _______ / ________ SS#_____
_______ ________
Date Joined the Original NPOAA:_________________________________
You Can Charge Your $35.00 NPSOAA Membership to your Credit Card.
Please Complete this Form and Fax it to: 908-226-8715.
Credit Card: ___Master Card ___Visa ___AMEX ___Discover
Card#:____________________________________________________
Expiration Date:_________ / _________
Name on Card:_______________________________________
Billing Address:______________________________________
City:_________________________State:____Zip:__________
Telephone: ________ ________________________________
E-mail:______________________________________________
Signature:___________________________________________
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