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New Membership Application
Annual Membership Fee $100
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* Indicates required question
Agency CEO Name, Email, Phone
Your answer
Which Accreditation format does your agency follow?
*
CALEA
ILEAP
BOTH
Required
Agency Name
*
Your answer
Agency Address
*
Your answer
City/Town
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Agency Phone Number
*
Your answer
Accreditation Manager
*
Your answer
Accreditation Manager's Email Address
*
Your answer
Accreditation Manger's best contact number
Your answer
Email addresses to be on THELIST- the I-PAC information sharing service
*
Separate by comma if entering multiple email addresses
Your answer
Payment Method
*
Please send payment within 14 days
Mailing check to: I-PAC Treasurer Bolor Bat-Erdem Elk Grove Village PD 901 Wellington Ave Elk Grove Village, IL 60007
Online via Credit Card ($2 service fee added)
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