APPLICATION
NAME:_____________________________
TITLE:_______________________________
AGENCY
NAME:____________________________________________________________
AGENCY
ADDRESS:_________________________________________________________
CITY/TOWN:
BUSINESS PHONE: (____)__________________
FAX: (____)_______________________
HOME
ADDRESS:___________________________________________________________
CITY/TOWN:
HOME PHONE: (____)__________________
E-MAIL:__________________________
MAILING PREFERENCE:
HOME______ OFFICE ______
FAX______
TYPE OF MEMBERSHIP: (Circle)
Active
Associate Corporate
Affiliate
Agency
CURRENT CRIME PREVENTION
ACTIVITIES:________________________________
____________________________________________________________________________
1.
Have you attended the
If yes, where and
when?______________________________ Hours attended:______
2.
Sponsor Requirements/Name(s):
Associate- 1 active member; Affiliate- 2 active
members; Agency- 1 active member; Corporate- 2
active/associate members
NAME:__________________________________
PHONE:_________________________________AGENCY:_________________________
NAME:__________________________________
PHONE:_________________________________AGENCY:_________________________
RETURN APPLICATION (with
appropriate dues) to:
CPA WNY
C/O the Office of Public Safety
71 Eastwood, Lower, Buffalo, NY 14208
Memberships
Active Member
($25 Annual Dues)
1. An Active Member shall be a current or retired Police
Officer (Peace Officer) as defined by the Criminal
Procedure Law of New York State.
2. An Active member shall be responsible to carry out
the mission and objectives of the Association.
3. An Active Member shall have voting rights, may serve
on committees, is eligible to hold office, must be a
Associate Member
($25 Annual Dues)
1. An Associate Member must be actively engaged as a
crime prevention practitioner and must exhibit an interest and desire to foster
the mission and objectives of the Association.
2. Associate Members must be sponsored by one Active
Member in good standing and approved by a majority vote of the Board of
Directors.
3. An Associate Member shall have voting rights, may
serve on committees, is eligible to hold a Trustee position, must be a
Agency Member ($75 Annual
Dues)
1. Agency Membership may be granted to law enforcement
and non-profit organizations (501 C3), community-based organizations or
neighborhood crime prevention programs which exhibit an interest and desire to
foster the mission and objectives of the Association.
2. Agency Members must be sponsored by one Active Member
in good standing and approved by a majority vote of the Board of Directors.
3. Agency Members may serve on committees and shall have one
vote collectively per Agency.
Affiliate Member ($25
Annual Dues)
1. An Affiliate Member is one who displays an interest
and desire to foster the mission and objectives of the Association.
2. An Affiliate Member must be sponsored by two Active
Members in good standing and approved by a majority vote of the Board of
Directors.
3. An Affiliate Member shall have voting rights an may
serve on committees.
Corporate Member
($125 Annual Dues)
1. Corporate Membership may be granted to corporations
or businesses, who have shown an interest and desire to foster the mission of
the Association.
2. Corporate Members must be sponsored by two Active or
Associate Members in good standing and approved by a majority vote of the Board
of Directors.
3. Corporate Members may serve on committees and shall
have one vote per corporation.