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NEW CLUB ADDRESS
10-13 Club of Northeast FL
POBox 291862
Port Orange FL 32129
LIVE Web, Additions Are Posted Daily

Recognized by the US Congress, the NYS Assembly, and the NYS Senate, as the representative union of retirees of ALL ranks of NYCPD http://nationalnycpd1013.org/
EVERY March 29th Is National Vietnam War Veterans Day




MEMBERSHIP APPLICATION
Dues for 2022 are Due, dues are $30.00 per year
and
"Life TIME" Members PAY $10.00 Assessment
Mail Dues to:
NEW ADDRESS
10-13 Club of Northeast Fl
PO Box 291862
Port Orange, FL 32129
Click The Link Below To Download The Application
PLEASE PRINT ALL REQUESTED INFORMATION
LAST NAME ____________________ FIRST _____________________ MI______
ADDRESS____________________________ CITY__________________ STATE_____
ZIP CODE_________ HOME PHONE (____ )________________ CELL (___)_______________ SPOUSE'S NAME _________________________ EMAIL ADDRESS ________________________
BENEFICIARY'S NAME FOR SURVIVOR’S FUND _____________________________
BIRTH DATE ____/____/______ ANNUAL DUES ARE $30.00 CHECK #_____________
APPOINTMENT DATE____/____/_______ RETIREMENT DATE ___/___/______
ATTACH Photo Copy
of DEPT ID
PENSION #(REQ'D)__________________ LAST COMMAND_____________ LAST RANK________
LIST ALL PREVIOUS COMMANDS ___________________________________________________
ASSOCIATE MEMBERS
LAW ENFORCEMENT AGENCY________________________TELEPHONE ( ) ________________
RANK_______ RETIRED ( ) ACTIVE ( ) MILITARY ACTIVE ( ) RETIRED ( )
Signature______________________ Date ____ /_____ /_______
MAKE CHECK PAYABLE TO: NE, FL 10-13 SEND to PO Box 291862, Port Orange FL 32129
ALONG WITH THIS APPLICATION
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