Ohio Association of Public Safety Directors
2017 MEMBERSHIP FORM
(April 30 ~ May 1)
Please provide the following information:
Municipality: ___________________________________
Name and Title: _______________________________________________________________
Office Address: ________________________________________________________________
City: ____________________________________________ Zip: _________________________
Office Phone: ________________________ Email Address: ____________________________
□
□
□
A.
Municipal Membership (Safety/Service Directors)
$ 75
B.
Individual Public Safety Membership
$ 75
C.
Associate Membership (Police and/ or Fire Chiefs)
$ 50
*********************************************************************************************
□
□
I will be in attendance at the 2017 Annual Spring Conference on May 5th.
□
I will be bringing a guest(s) to the 2017 Annual Spring Conference on May 5th at the cost
of $ 50.00 per guest.
I will NOT be in attendance at the 2017 Annual Spring Conference on May 5th.
Guest Name: ____________________________ Title: ______________________
Guest Name: ____________________________ Title: ______________________
Dues Amount
$ ___________
$50 for ___ additional guest
Total Enclosed
$___________
$___________
Anyone Interested In Joining the Board of Trustees Please Contact Josh Brown at
[email protected]
Please Return Forms with Payment to: The Ohio Association of Public Safety Directors
175 S. Third Street, Suite 510 Columbus, Ohio 43215
Please see reversed side for Membership Descriptions
Contributions, gifts or dues payments to the Ohio Association of Public Safety Directors are not
deductible as charitable contributions for federal income tax purposes. Consult your tax advisor if you
have questions.
Ohio Association of Public Safety Directors
Membership Descriptions
A: MUNICIPAL MEMBERSHIP: Any city or village in Ohio by proper action of its
legislative body and the payment of annual dues by the *municipality prescribed in
Article V, may become a Municipal Member of the Ohio Association of Public
Safety Directors. Municipal Members will be voting members for purposes of
membership voting.
B: INDIVIDUAL PUBLIC SAFETY DIRECTOR MEMBERSHIP: Any person
actively serving as a Public Safety Director or equivalent position in Ohio, by his or
her own action and the payment of annual dues by the **person prescribed in
Section 1.b, Article V, may become an Individual Member of the Ohio Association
of Public Safety Directors, regardless of whether his/her municipality is a member.
Individual Members will be voting members for purposes of membership voting.
C: ASSOCIATE MEMBERSHIP: Any active or retired Police Chief, active or
retired Fire Chief, or retired Public Safety Director in Ohio, by his or her own
action and the payment of annual dues prescribed in Article V, may become an
Associate Member of the Ohio Association of Public Safety Directors, regardless of
whether his/her municipality is a member, but may not serve on the Executive
Committee of the Ohio Association of Public Safety Directors. Associate Members
shall not be voting members for purposes of membership voting.
* Municipal checks are accepted for municipal memberships only; any membership
paid with a Municipal check will be classified as a Municipal Membership
** Personal checks or Money Orders are accepted for individual memberships.
If you have any questions concerning the membership please contact
Josh Brown, Executive Director
[email protected]
614-221-4349