National Association of Former Border Patrol Officers
Application for Membership

Attach personal check for dues (amounts shown below), then mail to
NAFBPO, P.O. Box 2012, Brunswick, GA 31521-0625
Name: Date of Birth:
Place of Birth:
(City, State, Country - if not born in U.S. explain the derivation of your U.S. citizenship on back of this form.)

Mailing Address
 
Email address

Phone Number (optional)
Applying for: Circle One
Senior Membership
($50 yr.)
Associate Membership
($25 yr.)
Supporting Membership
($15 donation or more yr.)
Memberships are always renewed during June. If you are applying in any other month, you should calculate how many months are left until June 1, then multiply by the proration shown here. The entire month in which you apply is free. Senior Member - $4.00 per month; Associate Member - $2.00 per month. There is no proration for Supporting Members - a contribution of at least $15.00 is required regardless of when it is made, and a further contribution of at least that much each June thereafter.
If seeking Senior Membership or Associate Membership please provide the following: Date, place, and position of entry on duty AND position, location, and dates of service that qualify you for the membership sought: It is not necessary that you list every position held; just one or more that fullfills the qualifications for the membership sought.


If seeking Senior Membership, provide date and place of honorable retirement or departure from Federal service.

If you seek Supporting Membership based on a contribution to NAFBPO, and you are not a U.S. citizen, please provide proof of legal status in this country. The best proof is a copy of both sides of your alien registration document with this form. A written statement on the back of this form attesting to your status from a Senior or Associate Member is also sufficient.
If you are seeking Supporting Membership based on marriage to a NAFBPO member (or are a surviving spouse), please provide the name of the member. You may join without paying dues or making a donation.
 

If you are unwilling or unable to provide documentary proof of qualifying service you may provide the name, address, and phone number of a current or former employee of a qualifying agency who will vouch for your claim to qualifying service, and dates of your service he can attest to. Please write the information on the back of this form.

Are you willing to assist in some way with the needs of the organization? If so, what are you willing to do, and what are your skills? Please use the back of this form.
Signature
  		Date
Information provided here will not be released to any individual or entity except as may be required by law or court order.

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