Application for Membership

 

Mid-Atlantic G.O.A.L.

 

The Mid-Atlantic Gay Officers Action League is organized to promote diversity, acceptance, and non-discrimination of all classes of persons in our communities and within the criminal justice profession through education, solidarity, and professionalism; To provide a network for education, support, and collegiality among gay and lesbian criminal justice professionals.

 

Instructions:     Application to Mid-Atlantic G.O.A.L. may be made by any person who is employed as a paid or volunteer, full time or part time peace officer, correctional officer, or other criminal justice professional, for any local, municipal, special governmental district, county, state, or federal government, regardless of location, or any person who is currently, or who has provided in the past, a special service to the law enforcement or criminal justice community.  Applications must be filled out legibly and completely.  Please submit you application online or return your completed application to Mid-Atlantic G.O.A.L. at 7758 Twin Oaks Road, Severn, MD  21144.  All information provided by you will remain confidential as provided for in the Association’s Bylaws.  Annual membership dues are $25.00. If paying for a partial year, the cost will be $3.00 for each month remaining in the Fiscal year.  (July 1st to June 30th) 

 

Please indicate the type of membership you are applying for:

 

    Active Membership.  Any person who is currently employed as a paid or volunteer, full time or part time peace officer, correctional officer, or other criminal justice professional, for any local, municipal, special governmental district, county, state, or federal government, regardless of location may apply for Active Membership.  Individuals who are retired but who would otherwise meet the above criteria are eligible for Active Membership.  Active members have full voting rights, may occupy positions on the Board of Directors and other committees, and other privileges as provided by these bylaws or Association’s Rules & Regulations.

 

    Affiliate Membership.  Any person who does not qualify for an Active Membership, but who is currently, or who has in the past, provided a special service to the law enforcement or criminal justice community, may apply for Affiliate Membership.  You must enclose with this application, a description of the contribution(s) you are, or have provided to the law enforcement or criminal justice community.  Affiliate members have full voting rights, may occupy positions on the Board of Directors and other committees, and other privileges as provided by these bylaws or the Association’s Rules & Regulations.

 

    Anonymous Membership.  Any person who qualifies for either Active or Affiliate Membership but who prefers to not have his identity disclosed for personal reasons, may apply for Anonymous Membership.  If membership is granted, the Anonymous member is only identified by a unique four-digit number assigned by the Secretary/Treasure.  Association Bylaws require that all members respect the Anonymous member’s request for privacy and anonymity, and shall make no attempt to determine his/her identity.  All applications will remain secured and their information unavailable for disclosure unless otherwise required by subpoena or court order.  

 

    Retired Membership.  Any person who is retired, having served as a full time or part time peace officer, correctional officer, or other criminal justice professional, for any local, municipal, special governmental district, county, state, or federal government, regardless of location may apply for Retired Membership.  Retired members shall have full voting rights, may occupy positions on the Board of Directors and other committees, and other privileges as provided by these bylaws or Association Rules & Regulations.

 

    Friend of GOAL.  Although not considered membership, a classification of “Friend of GOAL” is extended to any person who does not meet the criteria for membership as an Active, Retired or Affiliate member, but who wants to support the mission and goals of Mid-Atlantic GOAL with an annual financial contribution of fifty dollars.

 


 

 

The following information is needed only to determine eligibility.  Contact is not made with any employer.

 

First Name

Middle

Initial

Last Name

 

Gender

M / F / Transgender

Date of Birth

 

 

 

 

 

Home Mailing Address / Apt. / PO Box

City

State / Prov.

 

Postal Code

Country
   

 

 

Occupation

Number

Of Years

Rank / Title

If Applicable

Assignment or Duties

If Applicable

 

 

 

 

 

 

 

Employer’s Name / Address

City

State / Prov.

Postal Code

Country

 

 

 

 

 

Email Address

Home Telephone No.

Work Telephone No.
                               

 

May we contact you at your home? 

Yes  No

May we mail information to you at your home?

 Yes  No

May we contact you at your place of employment?

 Yes  No

May we mail information to you at work?

 Yes  No

May we contact you via your Email address?

 Yes  No

 

 

 

 

 

 

 

Payment Information

 

                    Pay by check made payable to GOALDC/Mid-Atlantic GOAL and sent to 7758 Twin Oaks Rd., Severn, MD  21144

 

 

                    Pay by Credit Card using Pay Pal. (Once application is received an invoice will be emailed to you with the pay pal link)

 

 

 

(If you are already a member, just fill in your name, address, contact number and email address and check how you are paying the fee.  If you want to use pay pal, once I receive the form from you I will email you the pay pal link so you can use a credit card.)