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NPRA Member |
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Associate Member |
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Name: |
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Address: |
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City:
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State: |
Zip Code: |
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Home Phone: |
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Social Security # |
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Work Phone: |
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Date of Birth: |
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Cell Phone: |
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Dept/Agency:(NPRA) |
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E-Mail |
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Division: (NPRA) |
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Spouse: |
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Supervisor (NPRA) |
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Child |
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Name: (NPRA) |
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Child |
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Phone#
(NPRA) |
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Child |
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For NPRA Members only |
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Qualifications (Persons eligible for membership) |
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(1) Must be either and active or retired police
officer |
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(2) An active
or retired reserve police officer |
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(3) A
full-time firefighter, employed by a municipal, county, state or federal
firefighting agency |
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(4) A Member of the
Military,active,retired or reserve. |
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(4) Also eligible for membership are any law
enforcement officer with proof of PC832 (arrest/firearms) |
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(5) The
immediate family and spouse of the law enforcement or firefighter. (Immediate
Family |
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is defined as:
mother,brothers,sisters,and offspring's,aunts & uncles. |
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(6) Spouse
& children 21 years and under of the associate members are also eligible. |
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(7) No
member of a professional rodeo association or organization will be eligible
for membership |
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if
they have received more than $2,000.00 in winnings the previous year in that
association. |
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(8) The qualifying officer or firefighter must
be a member of the NPRA, in good standing, for the |
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immediate family and or spouse to join. |
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(9) All members of NPRA must have proof of
medical insurance. |
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Applicants Signature:___________________________ |
Date: __________________ |
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Legal Guardian Signature: ______________________ |
Date:__________________ |
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Primary member must enclose a copy of I'D Card and a letter on your agencies
letterhead, from your |
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supervisor,
verifying your employment & copy of medical insurance card. Immediate family who are |
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applying for membership must enclose a copy of CDL
or School ID, birth certificate(s), or marriage license, |
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prove relationship & copy of medical insurance
card. |
New members need all items mentioned. |
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(NPRA does not carry insurance for members or
participants) |
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((over)) |
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Continued |
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General Membership
Dues_______________________________________________________________ |
$ 100.00 |
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Family
Membership_____________________________________________________________________ |
$ 150.00 |
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(If Post-Marked by February 28,
2011______________________________________________________ |
$ 75.00 |
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New
Members__________________________________________________________________________ |
$ 75.00 |
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Non-Competing Primary Member
(NPRA
Only)____________________________________________ |
$ 25.00 |
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Spouses or Children under 18 years of age
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$ 50.00 |
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Children over the age of
18______________________________________________________________ |
$ 75.00 |
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Each Member Must Submit an Application |
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RETURN APPLICATIONS TO: |
NPRA |
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10272 Juniper Rd |
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Oak Hills,Ca 92344-0304 |
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********************************************************************************************************************************* |
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Please do not write below this line. For official
use only |
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Membership # |
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Post-Mark Date |
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Amount Enclosed |
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Qualification letter |
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ID |
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Birth Certificate |
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Marriage Certificate |
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Proof of Insurance |
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******************************************************************************************** |
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