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LAWPOA Membership Application
LAWPOA Membership (New or Renewal)
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First Name
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Your answer
Last Name
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Your answer
Indicate Membership Requested
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Active LAPD Employee ($3.00 bi-weekly via payroll deduction)
Active City of Los Angeles Employee ($3.00 bi-weekly via payroll deduction)
Affiliate Member (Outside Agency) $78.00 per year
Emeritus Member (Retired) $25.00 per year
Agency Affiliation
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Your answer
Indicate LEO Status
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Sworn
Civilian
Sworn Retired
Civilian Retired
Rank and/or Title
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Your answer
Serial Number
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Your answer
Employee Number (City of Los Angeles Employees Only)
Your answer
Home Address
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Your answer
City
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Your answer
State
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Your answer
Zip Code
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Your answer
County
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Your answer
Phone Number
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Your answer
Email Address
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Your answer
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