WI Special Agents Association Membership Application
Open to Active and Retired Special Agents of the Wisconsin Department of Justice, Division of Criminal Investigation.
Name
*
First Name
Middle Initial
Last Name
Address
*
Street Address
Street Address Line 2
City
Please Select
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Texas
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West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Last 4 Digits of Social Security Number
*
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Are you a current Fraternal Order of Police member?
*
Yes
No
If yes, which lodge?
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Continue to Dues Payment
Membership Dues
*
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Active Membership Dues
$100.00
$
100.00
for the
first month
then,
$40.00
$
40.00
for each
month
Active Membership Dues (Pay Year in Full)
$480.00
$
480.00
for each
year
Retired Membership Dues
$60.00
$
60.00
for each
year
Associate Membership Dues
$100.00
$
100.00
for the
first month
then,
$37.50
$
37.50
for each
month
Associate Membership Dues (Pay Year in Full)
$450.00
$
450.00
for each
year
Email
Payment Methods
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Submit
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