Date: 
Name: 

College/University: 
Position: 

Address: 
City:  State:  Zip: 

Phone:  Fax: 

Membership Type: Institutional Associate= Sustaining Honorary and Retired

Email: 

Annual dues are payable by January 15 or at the time of application for membership, and apply for the calendar year. Annual dues and applications for membership received after July shall be reduced by one half and membership shall expire December 31. No member who has failed to pay dues to the treasurer shall be eligible to vote at the association meetings. The treasurer shall prepare a list of paid members for the president to determine eligibility to vote.

Please return this application and your check made payable to:

NCACLEA Membership Committee
Chief Mike Penry
Wake Technical Community College
9101 Fayetteville Rd
Raleigh, NC 27603
(919) 866-5532
mapenry@waketech.edu
NCACLEA Tax ID Number: 56-1152399

DUES	Classes of Membership and Eligibility
$100	Institutional- the director and/or assistant director of public safety, police, or security of every institution of higher education in North Carolina is eligible for membership.
$50	Associate- Employees, other than the Director or Assistant Director, who have a direct responsibility for provision of security or law enforcement services
$55	Sustaining- One who, by reason of avocation, profession of business interests, shares in the concerns and objectives of the Association and desires to demonstrate such support by membership.
No Fee	Honorary and Retired- The Membership Committee shall determine the criteria to be met in each individual case involving such membership.