Crime, crime free, training, Kansas City MO

Annual Membership Application

Name:_________________________________________ Rank/Title:_______________

Agency/Company:________________________________________________________

Mailing Address:_________________________________________________________

City:__________________________________State:_______ Zip Code:_________

Phone: (___)__________ Fax: (___)__________

E-mail: _________________________________________________________________

Your Agency/Company has implemented:

· Crime Free Multi-Housing

· Crime Free Hotel/Motel

· Crime Free Mobile Housing

· Crime Free Mini-Storage

· Other ________________

Are you interested and able to serve on a committee? Yes No

Are you interested and able to serve as a board member? Yes No

Dues are $25.00 per year for Law Enforcement and Associate members OR $75.00 per year for agencies/companies (provides for four memberships)

Make check or money orders to: Mid-America Crime Free, INC

Mail to: (or deliver to any current board member)

Mid-America Crime Free, INC
Bob Wise, Executive Director MACF
P.O. Box 480187
Kansas City, MO 64148-0187

Office use only:

Membership Accepted: Yes No (reason_________________________________________________)

Renewal or New? _________

Dues paid for: (year) ______

Hours of Operation:
Monday thru Friday
8 a.m. to 5 p.m.