Print out page and mail with your check Emerald Society Of Minnesota Irish American Police Association MEMBERSHIP APPLICATION/RENEWAL _____Active Police Officer ($20 ) ____NEW ____Retired Officer ( $10 ) ____RENEW ____Associate ($20) _____Address Change Name_________________________________________________ Dept/Agency______________________Title________________ Address_______________________________________________ City ___________________ State MN zip_______________ E Mail_________________________________________________ Telephone ( )_______________ Work ( )_____________
MAIL TO Emerald Society of Minnesota PO BOX 4423 ST. PAUL, MINNESOTA 55104-0423
www.emeraldsocietymn.org |