Membership Application Instructions

  1. Please click on the "Membership Application Form" link below to download an application form:

    Membership Application Form (pdf)
    Brochure (pdf)
    AD&D Insurance Summary (pdf)
    Insurance Beneficiary information (pdf)

  2. Fill out and then send in your completed application form along with a copy of your agency ID card to:

    Santa Clara County Peace Officer's Association
    P.O. Box 4629
    Mountain View, Ca 94040

  3. Please make payment by using the pull down tab under "Membership Types" to select your Agency. Then select the "Buy Now" button:

    Membership Types

SCCPOA Membership Refund/Cancellation Policy

Membership dues are non-refundable and memberships are non-transferable.

Information Collected:

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