| Northern New England Police Accreditation Coalition |
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| Number of Full Time Employees (agency size is based upon CALEA 5th Edition): A__ (1-24) B__ (25-74) C__ ( 75-299) D__ (300+) |
| Please indicate the interests of your agency with regard to the accreditation process (Check all that apply) [ ] NH Recognition process only, no CALEA interest. [ ] CALEA Recognition core standard program. [ ] NH Accreditation. [ ] CALEA accreditation. [ ] Agency has financially committed to the process and paid application fee. [ ] Actively in self-assessment in the State or CALEA process. [ ] Have achieved State Recognition/Accreditation [ ] Have achieved CALEA Recognition/Accreditation Membership Type (Check only one) [ ] Voting Member: NH, VT, or ME Law Enforcement Agency (Annual dues @ $50.00) [ ] Associate Member: Other Law Enforcement Agency or any governmental agency (Annual dues @ $50.00) [ ] Honorary Member: Must be granted according to NNEPAC by-law qualifications (No dues) |
| Please make checks payable to "NNEPAC" and remit payment along with this form to: Greg Murphy Manchester Police Department 351 Chestnut Street Manchester, NH 03101 |
| Membership Application and Dues Invoice: 2010 |
Department Name ____________________________________________________________________ Mailing Address _____________________________________________________________________ City ___________________________ State___________ Zip Code _______________________ Telephone ________________________________ Fax _____________________________________ E- Mail ____________________________________________________________________________ Chief Executive Officer: ______________________ Accreditation Mgr:_________________________ |