Norwalk Police Emerald Society, Inc.
I HEARBY APPLY FOR MEMBERSHIP in the NORWALK POLICE EMERALD SOCIETY, and make each of the following statements of facts, as personally known to me, intending that the Society rely upon the truthfulness of each in acting upon this application:
MAILING ADDRESS: _________________________________________________
PHONE: ______________________ E-MAIL: ______________________________
MEMBERSHIP: REGULAR ASSOCIATE
STATUS: ACTIVE RETIRED OTHER THAN P/O
SHIRT SIZE: ____________________
If elected to membership, I agree to abide by the Norwalk Police Emerald Society By-Laws, and by all future amendments, modifications, and changes thereto.
(Please make check out to: NORWALK POLICE EMERALD SOCIETY & return to
Ofc. K. Haddy of the Norwalk Police Department, 1 Monroe St., Norwalk, CT. 06851)