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Wisconsin Law Enforcement Officers Association

 MEMBERSHIP APPLICATION

Fill out the application below and become a member of the WLEOA,
the association dedicated to law enforcement -- our chosen profession.

Name: ____________________________________________________

Street: ____________________________________________________

City: _________________________________ State: _______________

Zip Code: _____________________ Phone Number: ________________

County of Residence: ____________________ WLEOA District: _______

Department: _______________________ Length of Service: ___________

                             Full Time:     Part Time: 

Social Security Number: _____-_____-_____ Date of Birth: ____________

Applicant Signature:___________________________________________

Member Sponsor: ____________________________________________

Date: __________________________

Active $20.00 Associate $20.00 (includes $3.00 for annual magazine}

Make your check payable to the WLEOA.

Please Mail Completed Application to:

 

Wisconsin Law Enforcement Officers Association

Randy Albert - Secretary

7731 Co. Hwy. II

Hatley WI 54440

 

 

You may also e-mail Secretary Randy Albert at: rsalbert@mail.co.marathon.wi.us