ONLINE MEMBERSHIP APPLICATION
  
Membership is restricted to sworn law enforcement, corrections officers, probation/parole officers, prosecutors, and criminal intel analysts.
  
Please contact the MGIA Membership Director with any questions: Email Membership Director
  
All applicant information is keep strictly confidential and will be used solely for membership identification and security purposes. The MGIA is a non-profit organization dedicated to the prevention and suppression of gangs and gang activity. By completing and submitting this application, the applicant agrees to adhere to the MGIA By-Laws. Applicant attests that he/she is at least 18 years of age as of this date, and a Sworn Law Enforcement Official or Criminal Justice Professional. Retired LEO is eligible with proper identification.  The MGIA Executive Board reserves the right to refuse membership to anyone and/or to suspend any member for violating the MGIA rules and By-Laws.
  
Applicants MUST provide a valid and unblocked email address on application form. Due to strict SPAM, virus, and email blocks that many agencies/employers are enforcing, please verify that you can receive incoming email messages from our listservers on your work email account, if you provided it to us. It is best to utilize a private, personal email account. If MGIA emails get bounced or are rejected from your email account, you will be removed from the Members Only website until another email address can be provided.
  
* All Required Fields must be filled out or Application will be void.
  
  
Applicant Information
  
Name: (Last, First, MI):
*
Home Mailing Street Address:
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Home Mailing City:
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Home Mailing State:
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Home Mailing Zip Code:
*
Date of Birth:
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Home Phone Number:
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Cellular Phone Number:
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Email Address:
*
  
Applicant Employing Agency Information
  
Agency Name:
*
Agency Street Address:
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Agency City:
*
Agency State:
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Agency Zip Code:
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Agency Phone Number:
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Title/Rank:
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Supervisors Name::
*
  
Additional Applicant Information
  
Check all that apply:
Active LEO: | Retired LEO: | New Member: | Renewal:
  
Mail Membership Card to:
Home Address: | Work Address:
  
Additional Comments:
  
Upload copy of Law Enforcement Identification:
*
* Proof of Law Enforcement employment must be provided or this form will be void!
  
I certify that I am a Sworn Law Enforcement Official or Criminal Justice Professional in good standing:
Agree: | Disagree:
  
I am paying for my membership dues via:
PayPal: | Mailing Check: | Voucher: | Other: (If other please list details in comments box)
  
Applicant Members Only Information
  
Username Email:
* Use a valid unblocked Email address
Password:
* Maxium eight (8) characters = numeric / alpha-numeric
Confirm Password:
  
I have read and agree to MGIA Terms of Use:
Agree: | Disagree:
  
  
After submitting this form you will be taken to a confirmation and PayPal payment page.
If paying via check / money order your membership will not be active until payment is received.
  
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