RETIRED MEMBER APPLICATION
Retired Black Shield members are retired or former public safety officers and first responders. Membership dues are $25/year and due at the time of acceptance. The Black Shield reviews applications on the 15th of every month. 

You will receive notification via email.
Email address *
First and Last Name *
Street Address, City and State *
Email *
Phone number *
How would YOU like to get involved with The Black Shield? *
Name of Former Public Safety Agency. *
Please include city.
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