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PoLEPFoR Membership Registration

Please complete this Application for Membership form as fully as possible.
First Name(*)
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Last Name(*)
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Address
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Suburb/Town/City
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State
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Country
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Email(*)
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Phone
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Rotary Club(*)
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Please record details of your Policing or Law Enforcement Service
Enter area of service e..g. Police, Customs,Military Police etc(*)
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Name of Agency(*)
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Length of Service(*)
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Status
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Rank(*)
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Captcha(*)
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