Application

Former Interpol Officers Association

Application

Active:
Associate:
Name of Applicant:
Residence Address:
Residence Telephone:
Email Address:
Name of Business:
Business Address:
Applicants Title or Occupation:
Beginning Date:
Ending Date:
Location: (Note: If IPSG please show Division, Sub-Division and Group; if NCB please show the Country and Job Title.)
Please list all Languages in which you are able to converse:
FIOA CHAPTER OF REFERENCE:
1:
2:
3:
Name of Spouse (or Significant other):
Name and address of relative (other than spouse) or close friend in the event of returned Mail:
Date of Application:
Signature of Applicant:

ANNUAL MEMBERSHIP DUES

ACTIVE AND ASSOCIATE MEMBERS

If application for membership is made on or after July 1st of any year, the amount of dues shall be $15.00. Annual Membership dues of $30.00 are then made payable on or after January 1st of each year there after. Funds are then deposited into the FIOA bank when received. If applicant is not admitted into membership the money they submitted will be refunded.