ACTIVE MEMBER APPLICATION
Active Black Shield members are retired or former public safety officers and first responders. Membership dues are $180/year or $15/month via payroll deduction, if you are a City of Cleveland employee. Dues are collected 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 Current Public Safety Agency *
Please include city.
Are you a current employee of a City of Cleveland Public Safety Agency? *
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