On Line
     Membership Application
or 
Copy and Mail in Application

2017
    
 


PDF APPLICATION    Renewal_Application.pdf
399.6 KB
 




NYS Shields
   On line Membership Application

2017

                   
Please fill out this form and click on the PAYPAL logo below to pay with your
Credit Card or use your Paypal account
NYS Shields Inc.

New Member/ Renewal / Law Enforcement / Associate
Agency / Command / Division
Rank / Title
Command Phone Number:
 First Name:
Last Name:
Home Address Street:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Comments:


                                                                                           

                                                                                                  
 
                             


The New York State Shields is a FEDERALLY recognized not for profit organization with 501 (c) - (3) status