GET INVOLVED

Join Our Community,

Make a Difference

Your support as a member, special event donor, or sponsor plays a vital role in our mission.

If you are a retired law enforcement officer who resides in the Low Country and are interested in becoming a member,

please complete the form below, or print it and mail an application.

Together, can create a lasting impact in our community!

Low Country Retired Law Enforcement Officers Association, Inc. Application

198 Okatie Village Drive, Suite 103-120, Okatie, South Carolina 29909

How did you hear about the LCRLEOA?

First name

Last name

Address

City

Zip/Postal Code

Phone

Birthday

Month

Day

Year

Department Name

Department Address (City / State / Zip)

Total length of sworn law enforcement service:

Type of sworn status (e.g., full time, reserve, part-time):

Separation Status (e.g., retirement, separation, disability):

Rank / Title at time of separation:

Areas of expertise (optional):

Interest in conducting volunteer training or presentations:

Yes

Additional Information

Please add any additional info here, i.e., service with multiple agencies.

Upload your retirement photo ID here.

Retirement Photo ID Required (please upload a copy or send it to the address below or to lcrleoa@gmail.com).

I certify that the information submitted in this application is true and correct to the best of my knowledge.

I further understand that any false statements may result in denial or revocation of membership.

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Date

Yearly dues of $40 are due with complete application and may be made:

by check to 198 Okatie Village Dr., Ste. 103-120, Okatie, SC 29909
via PayPal LCRLEOA@gmail.com, using friends/family
by credit card at: Low Country Retired Law Enforcement Officers Assoc - Low Country Retired Law Enforcement Officers Association