Membership Dues : NYPD Shomrim Society

Product Name
Name
First Last
Email
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Active or Retired?*
- Active
- Retired
Uniformed or Civilian?*
- Uniformed
- Civilian
Active: Rank/Title and Command*
Retired: Date, Rank/Title & Command*
Date of Birth*
Date Format: MM slash DD slash YYYY
Spouse Name (if applicable)
First Last
Spouse Date of Birth (if applicable)
Date Format: MM slash DD slash YYYY
I would like the monthly newseltter delivered by mail for $25.00 per year.
- No
- Yes
Note, Newsletter is available free online at on this website. Call or email for password.
Additional Cards ($16.00 for 15 cards)*
- No
- Yes
Optional Additional Donation
Total
$0.00
Credit Card

Card Details

Cardholder Name