Fifth District Citizens Advisory Council


Fifth District Citizens Advisory Council

Membership Form




FIFTH DISTRICT CITIZENS’ ADVISORY COUNCIL

MEMBERSHIP FORM
(print this form or join online)

5th District Police Headquarters

1805 Bladensburg Road, NE

Washington, DC 20002

 

*NAME

 

*STREET ADDRESS

 

*APARTMENT/SUITE

 

*CITY/STATE/ZIP CODE

 

*TELEPHONE/CELL PHONE

 

*E-MAIL ADDRESS

 

 

IN CASE OF EMERGENCY, PLEASE CONTACT:

 

 

DUES:  $10.00    (Annually)

 

Please complete the Membership Form and bring it with you to the next meeting, or you may mail it to the Citizens’ Advisory Council at the 5th Police District Headquarters (address listed above). You may include your dues with your membership form if you desire.  Please make your check Payable to:  5th District CAC.

 

YOU WILL RECEIVE YOUR REGISTRATION CARD AT THE NEXT MEETING YOU ATTEND.