PalmdaleSheriff Booster’s

MEMBERSHIP APPLICATION

Contact InformationMembership Type:

Access

Interests

Payment Information

Membership Includes:

Individual

NameStreet AddressCity/ST/Zip CodeHome PhoneWork PhoneCell Phone

E-Mail Address

New Member Referred By: _________________________ Approved by Board: _______________________________

Membership in Palmdale Sheriff Boosters will offer you the opportunity to meet with our first responders in a socialsetting. It also offers you the privilege of participating in special events which might not otherwise be available, suchas station tours and ride a longs with a Deputy.

1. Annual membership dues are $50.00 per person (Individual)2. Small Business $125.00 - 25 or less (one designated member only)3. Corporate membership $250.00 (one designated member only)

_______ I am interested in volunteering to assist with the committees_______ I am interested in serving as a Director

In addition to my dues, I would like to donate an additional $___________ to the Palmdale Sheriff Boosters

Membership CardMembership Certificate

Decal for Vehicle, Home, or Office

Mail Completed Application to:Palmdale Sheriff Boosters

750 E. Ave QPalmdale, CA 93550

Tax I.D. 95-4683976

Small Business Corporate

Please make checks payable to: Palmdale Sheriff Booster’s