Indiana State Fraternal Order of Police

Officer Roster Form

Officer Roster Form

Please provide the following contact information (* = Required Field):

Lodge Name/Number:	*
Lodge Mailing Address:
City:
State:
Zip Code:
Lodge Phone:
Lodge FAX:
Lodge Officers Term Begin:	(mm/dd/yy) *
Lodge Officers Term Expire:	(mm/dd/yy) *
Lodge Meeting Date:	(mm/dd/yy) *

President's Information

President:
Mailing Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
Email:

Vice-President's Information

Vice-President:
Mailing Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
Email:

Secretary's Information

Secretary:
Mailing Address
City:
State:
Zip Code:
Home Phone:
Work Phone:
Email:

Treasurer's Information

Treasurer:
Mailing Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
Email:

Enter the text shown in the image above.

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Indiana State FOP

1427 E Washington St
Indianapolis, IN 46201

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