American deputy Sheriffs' Association

Membership is Absolutely Free!

Simply fill out the application and press send at the bottom of this page, or feel free to print out a copy and give it to others who are interested in joining. Printed Applications can be faxed to us at: 318-398-9980 or mailed to us at 3001 Armand St., Ste. B, Monroe, LA 71201.

(Your membership packet will be mail within 90 days, please do not enter duplicate applications.)

All information gathered on the ADSA website is stored within an ADSA controlled database. The information you supply on your membership application is strictly confidential and will not be released.

Personal Information

Existing Member Making a Information Change Yes


Rank 


First Name      M.I.      Last Name  

Home Address     

City   State   Zip Home Phone    


E-mail     	Date of Birth    S.S.N.  

Your Sex            Male   Female

Beneficiary
(first & last name)  

Relationship To You

I am a: Commissioned Officer Reserve Other Department Employee

Department Information

 

Department Name  

Dept. Street Address   

Dept. City      

Dept. State    Dept. Zip  

Phone           Extension

I prefer to receive my ADSA mailings at: Home Department

Comments, Ideas, or Suggestions

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3001 Armand St., Ste. B • Monroe, Louisiana 71201 • Ph: 800.937.7940 • Fax: 318 .398.9980
501(c)(3) Non-Profit Charity • Charter No. 1422461 • Tax ID No. 76-0519780