Member Application

Become a Member

Initial charges: $5 Application Fee, $67.50 for Membership. Recurring: $67.50 on January 1st of each year.

"*" indicates required fields

To the officers and members of Hendricks County FOP Lodge #132

The undersigned, having a favorable opinion of your Honorable Order desires, if found qualified, to become a member thereof.

Witness my hand this day:*

Name*

Date of Birth*

Department*

Date of Hire*

Address*

Street Address Address Line 2 City State ZIP Code

Email(s)*

Cell Phone*

Work Phone*

Recommended by:*

Ballot Date

Fees:

$5.00 Application Fee - charged at time of application

$67.50 First Year Dues *

$67.00 Yearly Dues - charged January 1st each year

* If you are not selected for membership, you will be refunded the $67.50 First year dues.

Phone

This field is for validation purposes and should be left unchanged.

First payment: January 1, 2025