Membership Application – Police & Law Enforcement Professionals Fellowship of Rotarians

PoLEPFoR Membership Registration

Please complete this Application for Membership form as fully as possible.

Thank you for submitting the membership form. We will be in touch shortly.

Name

Address

Suburb/Town/City

State

Country

Phone

Rotary Club (*)

Please record details of your Policing or Law Enforcement Service

Enter area of service e..g. Police, Customs, Military Police, etc (*)

Name of Agency (*)

Status

Rank

Currently Working (Working, Retired, Resigned)