"*" indicates required fields Name* First Last Email* Username*Usernames can only contain lowercase letters (a-z) and numbers.Cell Phone*Title*Department/Agency*Department/Agency Phone*Date of Appointment, if applicableDepartment/Agency Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Billing Email Short History of Background in Law Enforcement*MembershipMembership Levels* Active Membership (Municipal/Campus/Federal/State Department Heads) Law Enforcement Associate Member – $175 Supporting Associate Member – $250 Life/Honorary Member (Retired Municipal/Campus/Federal/State Department Heads) – FREE Active Membership Annual Base Dues* Population of less than 10,000 – $601.00 Population of 10,001 to 20,000 – $756.00 Population of 20,001 to 49,999 – $962.00 Population of 50,000 or more – $1,174.00 Membership Add-Ons MPA Legal Defense Fund with MPA Annual Dues – $324 FOP Legal Defense Fund with FOP Annual Due – $456 MPA LDF AND FOP LDF with both Annual Dues – $780 NOTE: In the event you are looking for only partial coverage from the FOP LDF or only paying their annual membership, this will be done directly through the FOP Lodge by contacting Lisa Carroll (lcarroll@massfop.org) at the FOP.When did you retire?*From which department/agency?*Dates you where an active member*MCOPA Pocket Badge Yes, please send me a MCOPA Pocket Badge – $40.00 Total Payment Method* Credit Card Check/Invoice Credit Card* Δ
