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					                          EUROPEAN POLICE ASSOCIATION
                                  non-profit-making association
                                     Company 464.738.381
                                     Membership form

IDENTITY

NAME:                                         First name:

Date of birth:            City:                                   Country:

ADDRESS - TELEPHONE

Street:                                                           Number:     Box :

Postal code :                     City:                           Country:

Home telephone:                   Office telephone:               Fax:

E-mail:                                               Web site:

SERVICE INFORMATION

Police office:                            Date of entry:           Service:

Address:

Relevant experiences / Specialised skills / co-operation opportunities




HOBBIES

Do you have hobbies? Which one(s)?




Sponsored by (1):                                                 EPA membership nr

This form is to be sent to:
European Police Association, Montgras 160 B-1430 REBECQ (Belgium)
by fax (02/706.24.51) (+32 2/706.24.51) or by e-mail to info@europeanpolice.net

Subscription: 15 € to be transferred to account nr 979-6081799-01 of the EPA Montgras 160
B-1430 REBECQ (Belgium) (IBAN: BE43 9796 0817 9901 BIC: ARSPBE22)


(1) Sponsoring is not compulsory but is a plus.
                       EUROPEAN POLICE ASSOCIATION
                                non-profit-making association
                                   Company 464.738.381

                    Membership form - Sympathizing Member


IDENTITY
NAME:                                           First Name:
Date of birth                                   Place of birth


ADDRESS/TELEPHONE
Street                                                        N°                  Box
Postal Code                     City                            Country
Home telephone                                  Office telephone
GSM                                             Fax
E-mail                                          Web site
Profession
Motivation (1)


GENERAL DATA
If the association organises an activity in your area, would you be ready to accommodate one
or several members?          YES/NO             How many?
Do you have a hobby?            Which one?

Sponsored by (2):                                                  EPA membership nr


DATE                                                               SIGNATURE



This form is to be sent to:
European Police Association, Montgras 160 B-1430 REBECQ (Belgium)
by fax (02/706.24.51) (+32 2/706.24.51) or by e-mail to info@europeanpolice.net

Subscription: 15 € to be transferred to account nr 979-6081799-01 of the EPA Montgras 160
B-1430 REBECQ (Belgium) (IBAN: BE43 9796 0817 9901 BIC: ARSPBE22)

(1) Explain in a few words why you wan to become a symathizing member of the EPA.
(2) Sponsoring is not compulsory but is a plus.

Your application must be accepted by the Administrative Board.
In case it is rejecteed, subscription will be repaid.

Do not hesitate to visit our web site www.europeanpolice.net regularly
                       EUROPEAN POLICE ASSOCIATION
                                  non-profit-making association
                                     Company 464.738.381

                             Collective Membership form

IDENTITY
NAME:                                              First Name:
Date of birth                                      Place of birth
Street                                                           N°               Box
Postal Code                      City                              Country
Home telephone                                     Office telephone
GSM                                                Fax
E-mail                                             Web site

ACTING ON BEHALF OF
Service (1)                                        Unit/Division
Association (1)
Address
Number of members
Telephone                                          Fax
e-mail                                             Web site


GENERAL DATA
If the association organises an activity in your area, would you be ready to accommodate one
or several members?          YES/NO             How many?

Do you want to organise activities?       YES/NO
If Yes, which ones?
Further information/remarks




Sponsored by (2):                                                     EPA membership nr

DATE                                                                  SIGNATURE



This form is to be sent to:
European Police Association, Montgras 160 B-1430 REBECQ (Belgium)
by fax (02/706.24.51) (+32 2/706.24.51) or by e-mail to info@europeanpolice.net

Subscription: 60 € to be transferred to account nr 979-6081799-01 of the EPA Montgras 160
B-1430 REBECQ (Belgium) (IBAN: BE43 9796 0817 9901 BIC: ARSPBE22)

(1) To be filled in according to Police service status or Association status.
(2) Sponsoring is not compulsory but is a plus.
Do not hesitate to visit our web site www.europeanpolice.net regularly.

				
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