Santa Clara County Peace Officers' Association


SCCPOA New Memberships

To process your new membership application, we need the following information:

Completed membership application form, payment by check, and a copy of your departmental issued photo ID card (front & back side PC830-832.17). Please follow the steps below.


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

  2. Identify the correct membership classification that applies to you.

    LER

    • Law Enforcement Retired Membership
      Full-time sworn Peace Officers retired within Santa Clara County

    LE

    • Law Enforcement Membership Full-time sworn Peace Officers actively working within Santa Clara County

    ASC LE

    • Associate Law Enforcement Membership
      Full-time sworn Peace Officers active/retired working outside Santa Clara County

    OTHER

    • Associate Other Membership Federal/Special Agent/Officer, Correctional Officer/Deputy, Court Judge/DA, Deputy Probation Officer, Reserve Officer/Deputy, FireFighter/Investigator

  3. Please send completed Membership Application Form, payment by check, and a copy of your departmental issued photo ID card (front & back side PC830-832.17) to the mailing address below:


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

  4. Optional AD&D (Accidental Death and Dismemberment Insurance), Purchased Only Between December 1 – March 30th Annually.

    This optional insurance is valued at $15,000 and available for a nominal fee to our members. If you wish to purchase optional AD&D insurance, you must fill out, sign, and mail the "AD&D Insurance Beneficiary Form" linked below. Payments can be made by check for $15. For more information please click on the "Insurance Summary" pdf form.

    Payments made by check to:

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


  5. Optional Raffle Ticket Purchase, Purchased Only Between December 1 - March (2nd Saturday) Annually.

    TICKET COST = $100 each
    Each tax deductible donation of $100 or more will be entered into the drawing.
    The SCCPOA Raffle will be held on March 9th, 2019


    Raffle (pdf)


    Payments made by check to:

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



Membership questions: General questions:
Please email: membership @sccpoa.org Call the SCCPOA main office at 408-264-1224

YEARLY MEMBERSHIP is effective Jan. 1 - Dec. 31 (Note if joining after Oct. 1 the following year's membership is included).

I hearby authorize the SCCPOA to confirm and verify my status as a bondafide Police Agent or Officer for the Agency listed in the application. I realeased any individual, organization or agency from any and all liability incurred as a result of providing such information.


SCCPOA Membership Refund/Cancellation Policy membership dues are non-refundable and memberships are non-transferable. The Santa Clara County Peace Officers Association reserves the right to refuse/cancel a membership in the SCCPOA. If SCCPOA refuses a new or renewing membership, registrants will be offered a refund. Information Collected: Our website does not automatically collect any individually identifiable information. Your privacy is important to us, and we are committed to protecting it. We will never disclose or share your personal information without your express written consent. Secure Checkout is provided through PayPal. PayPal uses the latest in data encryption and anti-fraud technology to keep your information secure, reducing the risk of online fraud.