ITA MEMBERSHIP APPLICATION
Print this form and return via mail or fax to us with $20.00 in membership dues.
Indiana Troopers Association, Inc.
PO Box 798
Angola, IN 46703
Fax: (260) 624-2747 Phone: 1-800-671-9851
  • YES! I want to join the ranks!:
    First Name
    Middle Initial
    Last Name
    Address
    City
    State
    Zip
    Date of Birth
    Phone
    E-Mail
    PE #
    Rank
    District
    Department
    Beneficiary
    Relationship to Beneficiary
    Appointment Date
    Credit Card Number Visa and MasterCard
    Expiration Date
    If Retired: No Dues Required however a donation for the magazine would be greatly appreciated.
     Retirement Date
    Please Select One

    ISP Dailies   None

    Dayplanner (generic 2-pg per week)

    • PRINT

    Membership materials will be sent upon confirmation of eligibility. If you have any questions or comments please contact us at 1-800-671-9851.