» Print Application

As a member of the Crimestoppers Club, you can help make a real difference in your area. Join today! Print and mail this form with your check to:

P. O. Box 55249,
Metairie, LA 70055-5249.

For more information on the Crimestoppers Club, call (504) 837-8477 or write to the address above.

Yes, I want to fight crime in my neighborhood! I am sending the enclosed contribution to support the efforts of the Crimestoppers Club. Please enroll me in the membership category I have selected below:

Individual Memberships:

___ $ 50.00 – Associate Member
___ $ 100.00 – Family member
___ $ 500.00 – Small Business
___ $ 1,000.00 – Benefactor

Corporate Sponsorship: (more information)

___ $ 1,500.00 – Officer
___ $ 3,000.00 – Sergeant
___ $ 5,000.00 – Captain
___ $10,000.00 – Deputy Chief
___ $25,000.00 – Chief of Police

Name on Membership:	____________________________
Name:	____________________________
Company:	____________________________
Address:	____________________________
City / State / Zip:	____________________________
Phone / Fax:	____________________________