HOUSTON POLICE RETIRED OFFICERS ASSOCIATION
APPLICATION FOR NEW ASSOCIATE MEMBER

This form is not for Houston Police Department retirees, or those currently in the DROP program; those applicants should complete a regular New Member Application
All Associate Members must be sponsored by a current HPROA member.  IMPORTANT: Review HPROA Associate Member Guidelines and Benefits before applying.
Please do not leave any of the below fields blank.  Enter NA if not applicable.  Note: Applications can take up to 2 months for board approval and processing per HPROA's by-laws.
First Name: (in full) *

Last Name: *

Spouse's Name:

Cell Phone: *

Home Phone:

Email Address: * 


  Home Street Address: *

City: *

State: *

Zip Code: *


All Associate members Must have a HPROA Sponsor; My Sponsor Is: *



Retired Law Enforcement Officers Only

If you are an active or retired police officer (other than HPD), or prior officer, you must complete the following info: 
Employer / Retired From:

Position Held:

  Date Sworn In:

If former HPD, I left because:
 

Associate Membership Dues:

Associate Renewal Membership is $50.00 per year.  A voluntary PAC contribution of $25.00 or more is suggested.  For those contributing with corporate funds, the donation will instead go to the Family Assistance Committee (FAC), rather than the PAC.  Renewal notices will be mailed one month prior to annual expiration. 

Annual Dues:  $50.00

PAC Donation:
(Suggested Amount) 
$

PAC Donation Requirement per Texas Ethics Commission:
 *
(Current Employer & Position, or if Retired, Last Position Held)


TMPA Legal Defense:  (If Yes $40 Fee) *  This optional coverage is only available for Texas Honorably Retired TCOLE Law Enforcement Officers from agencies other than HPD.

Yes No 

Required for TMPA Legal Defense: * I certify that I am an Honorably Retired TCOLE Texas Law Enforcement Officer having retired from: 
Total Amount Due:
$

YOU WILL BE PROMPTED TO PRINT THIS FORM AFTER  CLICKING "SUBMIT APPLICATION.
IF YOU ARE PAYING VIA CREDIT CARD - YOU DO NOT NEED TO PRINT / MAIL IN THE FORM. 

You should receive an email confirmation within a few minutes. If not, please call the below phone number for assistance. 

IF PAYING BY CHECK, MAIL PAYMENT AND SIGNED APPLICATION TO:

HOUSTON POLICE RETIRED OFFICERS ASSOCIATION
P.O. BOX 130787, HOUSTON, TX  77219
Call (713) 802-2967 or 1-866-856-7252 with any questions

Please sign below if you are submitting this form by mail.



Signature:



Method of Payment:
 Pay By Check - Print Application and Mail    Credit Card

Credit Card Information (all fields required)
Card Type

Cardholder's First Name

Cardholder's Last Name

Credit Card Number

Exp Date
(e.g.: 05/2020)
Security Code

 

Cardholder's Billing Street Address

Billing City

Billing State
(2-digit state code)
Billing Zip Code

Billing Country
(2-digit country code)

CHECK TO AGREE: I understand that current Associate Membership in the Houston Police Retired Officers Association is a privilege that allows me the opportunity to attend and participate in all regular meetings and association functions. I understand that I can not vote or propose a motion on any issue that may be brought before the Regular Membership for action.

I understand that I can not stand for any election or serve as chairman of any committee, but can serve on a committee if I so desire and I am approved by the HPROA President. I certify I have not been arrested, charged, indicted, tried and/or convicted - adjudicated or non-adjudicated - for any felony or for any misdemeanor involving moral turpitude. [City/J.P. Court traffic offenses are exempted]