reserve police officers,auxiliary police officers,reserve deputies,reserve constables,reserve police association,reserve police insuranceMembership Printable Membership and Renewal Form
BenefitsHome Page
 
 

 Img7.png

NRLO MEMBERSHIP FORM
See Benefits for details on Memberships and newly added Benefits
Print this page and mail to: NRLO P.O. Box 6505  San Antonio, Texas 78209
or Contact NRLO for Group Rate and/or Membership/Information Forms and say how many you require.
  

NRLO Premium Membership - $45 yearly* 

Please check and fill in all blanks that apply:                                                     Date of Application:
1 NEW MEMBER  1 RENEWAL MEMBER #:                             1 
$45 Yearly Individual Dues        Additional Forms Needed_____    
**************************************************************************************************************************************************************************
LAST NAME:                                                                FIRST/MIDDLE:                                                            D.O.B. (YY/MM/DD):
**************************************************************************************************************************************************************************
MAIL ADDRESS:                                                                             CITY:                                                   STATE:                    ZIP:
**************************************************************************************************************************************************************************
TITLE/RANK:                                                   1Reserve 1Auxiliary 1Regular 1
Other:                               Date Sworn(YY/MM):
**************************************************************************************************************************************************************************
HOME PHONE:  (      )                                        WORK PHONE: (      )                                           DEPARTMENT PHONE:  (      )
**************************************************************************************************************************************************************************
Optional:  PERSONAL E-MAIL:                                                 BUS. E-MAIL:                                                FAX:  (      )                    **************************************************************************************************************************************************************************
Optional:  Full-time Job Description (if you are a Reserve):
**************************************************************************************************************************************************************************
Department:                                                                               Name of 1 Sheriff 1 Chief of Police 1
Other:
**************************************************************************************************************************************************************************
Dept./ Address/City/Zip:                                                                                                                                     #Reserves:           #Regulars:
**************************************************************************************************************************************************************************
Unit Leader Title: 1Coord.1Liaison
1Cmdr.1Pres.1Chief1
Other:                     Name:                                                              1Res. 1Reg.
**************************************************************************************************************************************************************************
Optional:  TRAINING: Total Hrs.:         Basic Hrs.:        Intermed. Hrs.:        Adv. Hrs.:       In-House Hrs.:      /(Wk)(Mo)(Yr)  Other:
**************************************************************************************************************************************************************************
Optional:  Comments on Training:
**************************************************************************************************************************************************************************
Optional:  AUTHORITY/COMMISSION which qualifies and certifies Reserves:
**************************************************************************************************************************************************************************

NOTE:  Beneficiary names and addresses must be on file in NRLO's Computer Records; please supply information below:
INSURANCE BENEFICIARY NAME:                                                                           RELATIONSHIP TO INSURED:
**************************************************************************************************************************************************************************
BENEFICIARY ADDRESS/CITY/STATE/ZIP:                                                                                                                   PHONE: (      )       
**************************************************************************************************************************************************************************
Optional:  REMARKS/ (Examples: "How Often and Where your Unit meets" or "Comment from Dept. Leader" or "Brief Summary on your Law Career):

 


 

* Dues are non-refundable
**************************************************************************************************************************************************************************
Insurance coverage effective on receipt of payment.
Back to top of Form 

 

Benefits | Home Page