To apply
for a new membership, or to renew your current membership
please fill out
and send in our form.
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MICHIGAN POLICE COMBAT Membership Renewal Invoice |
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| Remit to: MPCPA 813 N. Gould St. Owosso, Mi. 48867 |
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| Members Name: DOB: |
| Address: Circle Division: Police Civilian |
| Name Of Department: |
| Phone Number: If New Member indicate by circling:Yes |
| Work Phone: Email Address: |
| Cell Phone: |
| **** IF ANYONE WANTS TO SHOOT IN THE POLICE DIVISION, YOU MUST PROVIDE A COPY OF VALID ID'S **** |
Membership Type (Check Box That Applies) |
U.S. Funds |
Check Box |
Canadian Funds |
Check Box |
65 & Over Club |
Check Box |
New Member |
Check Box |
Amount |
| Indoor Season | $30 |
$40 |
$25 |
$30 |
________ |
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| Outdoor Season | $30 |
$40 |
$25 |
$30 |
________ |
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| Both Indoor & Outdoor | $50 |
$65 |
$25 |
$30 |
________ |
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| Name of new member you sponsored last year | |||||||||
| Name of member who sponsored you this year | |||||||||
Sponsorship Discount: |
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Total Amount Due: |
________ |
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Dues will be accepted through the Indoor Oakland County Match to have scores count for the Indoor Season. 65 & Over Club: You must be 65 at the time you pay your dues. |
MEMBERSHIP DISCOUNT PROGRAMNew Member: If you are a new member or have not been a member for the previous 3 consecutive years, you can join for a one-time membership price of $30 US or $40 Canadian. This will be for the calendar year you join only. Please remember to notify the treasurer of any changes of address, phone numbers, email, etc. or you could miss mailings. |
Revised 1/05 |