Davidson County FOP Lodge 97
Membership Application must be completed in full
  • Please indicate which type of membership you are applying for.
  • Please use FULL legal name
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    Please list number that you are MOST likely to be reached at.
  • Please give us your PERSONAL email that you actually CHECK
  • Must have for legal purposes. WILL NOT BE GIVEN OUT
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  • I understand the legal defense plan will not go in effect until the first day of the next month after my application is accepted by the NC State FOP Lodge. If I do not follow the outlined steps for the legal aid plan (https://www.ncfop97.org/legal), I understand the lodge, its members nor its executive officers are responsible for any legal fees stemming from any actions connected with my employment. Any actions taken on my part will be at my own expense.

    I understand that I am responsible for prompt payment of all dues and if I do not keep my dues current I will be dropped without further notice and lose all rights and benefits of the plan into which I enrolled.

  • STATE/LOCAL LODGE INSURANCE BENEFIT ASSIGNMENT:

    In the event of an untimely death, either natural or line of duty, I designate the following beneficiary(s) to receive any and all funds entitled to me as a member of the Fraternal Order of Police, if any, and of which my state or local lodge may have paid a life insurance premium.

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  • Applicant MUST put Full Name in place of "TYPE YOUR NAME HERE"
  • This "Electronic" Signature hereby stands as my written signature for all legal purposes.
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