Fraternal Order of Police Capitol City Lodge #19
Retired Membership Application

Full Name ____________________________________________________________

Date of Birth ________________________

Address _____________________________________________________________

City ________________________ State __________________ Zip ___________

Phone Number ___________________ Best Time to Call _________________

E-Mail _______________________________________

Agency ___________________________________ Rank ____________________

OATH OF OBLIGATION

I, _______________________________, in the presence of the Creator of the Universe and the members of the Fraternal Order of Police here assembled, do most solemnly and sincerely promise and swear, that I will to the best of my ability comply with all the laws and rules of this Order; that I will recognize the authority of my legally elected officers and obey all orders therefrom not in conflict with my religious or political views, or my rights as an American citizen; that I will not cheat, wrong, or defraud this Order, or any member thereof, or permit the same to be done if in my power to prevent it; that I will at all times aid and assist a worthy Brother or Sister in sickness or distress, so far as it lies in my power to do so; that I will not divulge any of the secrets of this Order to any one not entitled to receive them. To all of which I most solemnly and sincerely promise and swear. Should I violate this, my solemn oath or obligation, I hereby consent to be expelled from the Order.

Signed:_______________________________ Date:___________________________

Lodge dues $20.00 per year cover national state and local dues as well as all other benefits of membership.

Print, sign and send this application with your Dues to:

Jeff Wolfe
3646 SW Grotto Ct
Port Orchard WA 98367