Membership Application
General (All members complete this section.)
First/Last Name*:  
Email*:
  
Street1*:  
Phone*:
  
Street2:  
Cell:
  
City/State/Zip*:  
Agency (Members of law enforcement agencies complete this section.)
Name:  
Phone
  
Street1:  
Years of Svc:
  
Street2:  
Years of K9:
  
City/State/Zip:  
Rank:
  
 
Other
  

Vendor (Members of vendor companies/agencies complete this section.)
Name:  
Phone
  
Street1:  
Position
  
Street2:  
Other
  
City/State/Zip:  

Partner (Canine handlers complete this section.)
Partner Name:  
Call Sign:
  
Age:  
Breed:
  
Years of Service:  
Speciality:
  
Certification:  

Make checks payable to:

LACPCA
P.O. Box 221928
Newhall, CA 91322

Fax: 714-736-9710

Regular Member $25.00
Any full time peace officer employed by any government agency
that is or was a K9 handler, trainer or supervisor.

Associate Member $15.00
Any person interested and supportive of K9, any K9 non-peace
officer Renewal New Member