Associate Membership – Lake County Sheriffs Police Lodge #66

Associate Membership Application

By filling out this application you agree to all of FOP Lodge 66's By-laws

Were you a member last year and wish to renew your application?

Full Name

E-Mail

Primary Phone Number

Birthdate

Address

City

State

Zip

Are you currently a member of another FOP Lodge?

If yes, then state and lodge number

Why do you wish to become a member?

Employer

Position

Are you a business owner?

If yes, what business?

Signature

Date

If you have not been a member of the Lake County Sheriff’s Police FOP Lodge 66 in the past, do not pay your dues until your application is approved by the executive board. All fields are required. Failure to complete the application in its entirety will result in your application being denied. Completion of this form does not ensure your membership request will be approved. The executive board and active members of Lodge 66 reserve the right to refuse and/or revoke associate membership at any time. Dues can be paid starting on November 1st of the previous year to July 1st of the current year to stay an active member. If your application is approved, you will be contacted by the executive board and given instructions on how to pay your dues.