AFRICAN AMERICAN POLICE LEAGUE
1403 East 75th Street #2 Chicago, Illinois 60619
Phone# - 773-256-AAPL E-mail address - aapoliceleague.org
MEMBERSHIP APPLICATION

(CIVILIAN)
ANNUAL DUES $50.00

NAME_____________________________________

ADDRESS ______________________

CITY ___________ STATE _____

TELEPHONE # HM. ______________

CELL _______________

DISTRICT OF RESIDENCE ________

D.O.B. ______________

Paid in full. Expiration _________

Signature ______________________
                      (Member)

Signature ______________________
                     (President-AAPL)