CALEBI - Membership Application Form

Membership Application

Utilizing the form below you many submit your membership application and directions are provided below as to where to send your check for payment. If you would prefer to mail in the application, CLICK HERE, print it out and mail it in with your check. To access the Application Form you will need the Acrobat Reader installed on your computer. If you do not have it, you may download it for free by CLICKING HERE and follow Adobe’s instruction to download and install it.
All fields are required to be completed
For Year

Membership Type	Active - applies to Law Enforcement Agencies within the State of California Associate - applies to members of Law Enforcement "Support Agencies" after review of the Board of Directors.

Application Type	New Renewal
Dues are $100.00
Agency
Last Name
First Name
Address
City
State
ZIP Code
Telephone
E-Mail Address:

I acknowledge that by completing this form, all facts are true and that I will mail the dues of $100.00 for membership as a Representative or Active Member to the following address:

CALEBI
Attn: Robert Keranen
Santa Rosa Police Department
965 Sonoma Avenue
Santa Rosa, CA 95404
Telephone: 707.543.3584

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