Member Dues Payment

If you are a State Organization or looking to establish an accredited program and would like to join AccredNet, please complete the form below and submit payment.

"*" indicates required fields

Name of Person Submitting this Form*

First Last

Your Email*

Your Title

Organization Information

Your State Organization Name*

State Organization Address

Street Address Address Line 2 City State ZIP Code

Number of Full-Time Police Officers

Number of Part-Time Police Officers

State Organization / Program Website

Logo/Patch Upload

For established department and agencies, please upload a image file of your logo or patch.

Accepted file types: jpg, png, pdf, Max. file size: 50 MB.

Are you an established State Accreditation Organization or looking to start a program?*

Yes, established agency

No, looking to start a program

Program Type*

State Sponsored Program

State Chiefs Association

Other

Chief Executive Officer

Chief Executive Officer (Name & Title)

Phone

Accreditation Manager

Accreditation Manager (Name & Title)

Phone

Additional Member Information

List of your organization/department board members (Please click "+" to add additional members)

Name

Title

AccredNet Annual Membership Dues

Price:

Total AccredNet Annual Membership Dues

Credit Card

Cardholder Name

Card Details

Member Dues Payment

Organization Information

Chief Executive Officer

Accreditation Manager

Additional Member Information

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