NACOLE Organizational Membership Form

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Apply for an Organizational Membership

Organizational Members are defined as agencies or boards who provide civilian oversight of law enforcement by legislative or executive mandate. These agencies or boards will receive one transferable regular (voting) membership. All agency or board affiliate members are eligible to serve on committees, however election or appointment to the Board of Directors shall be limited to the designated voting member of the agency or board. Cities or other political subdivisions may obtain one organizational membership to cover all of the entities within it, which meet the requirements for regular membership.

Below, please include each member who is to be included as part of your organizational membership. This should include the agency head and all staff of your organization.

Organizational Member

I would like to automatically renew my membership

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Organization Name *

Address Line 1

Address Line 2

City

State/Province

Zip/Postal Code

Country

Business Phone

First Name *

Primary Contact

Last Name *

Email *

Secure Payment

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Include an affiliate member

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Choose Existing Contact(s)

Membership Level *

I would like to automatically renew my membership

First Name *

Last Name *

Job Title

If this person is either your agency's Designated Voter or Invoice Contact, please check the appropriate box below.

Designated Voter

Invoice Contact

The Designated Voter cannot be a sworn member of a law enforcement agency. The invoicing contact will receive renewal reminders.

Add {{subMemberDisplayName}}

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Discount Code

Code:

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Order summary

Subtotal {{formatAmount(orderSummary.subtotal)}}

Discounts -{{formatAmount(orderSummary.discounts)}}

Total {{formatAmount(orderSummary.total)}}

Secure Payment

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Card

Pay Later

Cardholder First Name *

Cardholder Last Name *

Cardholder Email

Card Number *

Expiration (MM/YY) *

CVV *

Billing address is the same as mailing address

Address Line 1

Address Line 2

City

State/Province

Zip

Country

I will mail in a check or money order

Please mail your payment to:
P.O. Box 20851
Indianapolis, IN 46220

Please note: Your membership will not be active until payment is received.

Amount:

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Membership level allows for a maximum of {{term.subMemberAllowed}} submembers.

	Contact Name	Membership Level
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No contacts.