WLEEDA MEMBERSHIP APPLICATION

Name: ____________________________________

                     Last                         First                        MI

 Address:__________________________________

 City: __________________State_____Zip_______

 Phone: (     ) _____________________

 Department ________________________________

 Rank _____________________________________

 Email _____________________________________

 I am a Graduate of  (Check all that apply)

 (   ) Criminal Justice Executive Development Institute

 (   ) FBI National Academy

 (   ) SPI – Southern Police Institute

 (   ) Northwestern Staff & Command

 (   ) Other ______________________________________

 Class Number and Graduation Year ________________  

Annual Membership Fee is $25

Make Check Payable to:

W.L.E.E.D.A.

C/O David Laude
Wood County Sheriff's Dept.
400 Market St.
Wisconsin Rapids, WI 54495
(715)421-8700