HAPS Member Reinstatement Form

HAPS Member Reinstatment Form
Use this form if you are seeking membership reinstatement ($40.00 U.S.)
Full Name*

First NameLast Name
Date attended Frances Glessner Lee Homicide Seminar (Month/Year)
Duty Status

ActiveInactive
Rank/ Title
Sponsoring Department/Agency/Business Name
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business Phone Number

Area CodePhone Number
Preferred E-mail Address*
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone Number

Area CodePhone Number
Enter the message as it's shown*
Should be Empty: