Membership Application

LASCP Membership Application

Please fill out all information below and submit, we will follow up with an email as soon as we receive your application.
we look forward to having you join our organization, Thank you for considering LASCP.

* Indicates required field

Name *

First

Last

Best Email for LASCP Information *

Your Personal Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Date of Birth *

Your Cell Number *

My choice of communication *

Email Text A Phone Call Snail Mail

Department Information

Department Name *

Department Mailing Address please include zip code *

Chief of Police *

Your Office Phone Number *

Date Hired *

Position with Department *

If position is not Secretary to Chief please list duties *

Department or City Website *

Submit