AMERICAN POLICE

CANINE ASSOCIATION

Membership Application

Send payment to

A.P.C.A.

c/o Michael Johnson

P.O. Box 382 Bedford, IN 47421

 

ANNUAL DUES: Regular and Associate Members $35.00

Name
Address, City, State and Zip
Department Name
Department Address
City
State/Province Zip Code
Home Phone
Your E-Mail Address

Work Phone Alternate Phone

 

Are you a Law Enforcement Officer?

Do you have Statutory Arrest Powers?

Are you and your Canine Used by your Law Enforcement employer?

Canine Name Canine Age/Sex Canine Breed/Color



Associate Members: Please fill out with Name, Address, Phone number and Name of member Sponsoring you.