Join Now – Scottsdale FOP Lodge #35

Contact Information

Name(Required)

First Last

Date of Birth(Required)

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Home Phone(Required)

Work Phone(Required)

Pager

Mobile

Employer Information

Employer(Required)

Occupation / Rank

Work Address(Required)

Street Address Address Line 2 City State ZIP Code

Membership Information

I hereby apply for membership in the "Fraternal Order of Police/Arizona Labor Council, Inc." (FOP/ALC). I authorize the "FOP/ALC" to act as my official representative in all job related matters concerning my wages, hours, and conditions of employment in order to promote and protect my economic welfare. Further, in the presence of the Creator of the Universe and the members of the Fraternal Order of Police, do solemnly and sincerely promise and swear, that I will, to the best of my ability, comply with all the laws and rules of this Order; that I will recognize the authority of my legal elected officers and obey all orders therefrom not in conflict with my religious or political views, or my rights as an American citizen; that I will not cheat, wrong, or defraud this Order, or any member thereof, or permit the same to be done if in my power to prevent it; that I will, at all times, aid and assist a worthy Brother or Sister in sickness or distress, so far as it lies in my power to do so; that I will not divulge any of the secrets of this Order to anyone not entitled to receive them. To all of which I most solemnly and sincerely promise and swear. Should I violate this, my solemn oath of obligation, I hereby consent to be expelled from the Order.

Signature(Required)

My ALC dues will be paid:(Required)

Through my local Lodge # 35 by check or cash for the calendar year

Direct deposit by debit from my checking account

Debit Authorization

I (we) hereby authorize THE FRATERNAL ORDER OF POLICE, ARIZONA LABOR COUNCIL, INC. (hereinafter "FOP/ALC") to initiate debit entries to my (our) Checking account indicated below at the financial institution (hereinafter "DEPOSITORY") named below, to debit the same of an amount not to exceed $25.00 per month, ($20.00 ALC dues and $5.00 to Lodge 35) to such account on or between the 25th to the 28th of each month. Transactions will begin the month following the date of this authorization.

My Deposiory Name(Required)

Bank, credit union, etc.

This authorization is to remain in full force and effect until the FOP/ALC has received written notification from me (or either of us) of its termination in such time and in such manner as to afford the FOP/ALC and my (our) DEPOSITORY a reasonable opportunity to act on it.

Routing Number(Required)

Account Number(Required)

Signature(Required)

Contact Information

Employer Information

Membership Information

Debit Authorization

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