Member Enrollment / Roster Information

Denver Police Retirees Association

Member Type *

Current Member — Information Change OnlyNew Paying Member — Full BenefitsRoster Information OnlyNon Member

Personal Information

First Name *

M.I.

Last Name *

Nick Name

Badge # *

Year Retired *

Spouse / Partner Name

Contact Information

Email Address *

Primary Phone

Secondary Phone

Primary Address

Street Address

City

State

Zip

Seasonal Address (optional)

Street Address

City

State

Zip

Seasonal Phone

Preferences

Membership Booklet

Add me to the membership bookletDo NOT add me to the membership booklet

Do NOT show my information in the roster

Additional Information

Comments or additional details

Denver Police Retirees Association — denver@dpra.info