Membership Application Instructions

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

    Membership Application Form (pdf)
    Brochure (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

AD&D Insurance Instructions

  1. Please click on the "AD&D Insurance Form" link below to download an AD&D Insurance form:

    AD&D Insurance Summary (pdf)
    Insurance Beneficiary information (pdf)

  2. Fill out and then send in your completed AD&D Insurance Summary/Beneficiary form to:

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

Membership & AD&D Insurance Payment

Please make payment for Membership or Optional AD&D Insurance by using the pull down tab below. Then select the "Buy Now" Button.

Membership Types / Optional AD&D Insurance

SCCPOA Membership Refund/Cancellation Policy

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

Information Collected:

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