Membership Application

Application Form

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Please fill out this form completely and be sure to click the submit button at the bottom of the page. The form will change to show you what has been successfully submitted and you will also receive a confirmation by email. You can also pay* your first year's dues on-line at our "home" page - www.mcpalumni.org.

Or, if you prefer, print out your confirmation and mail it with your check* in the amount of $30.00 payable to to MCP Alumni Association, P. O. Box 431, Damascus, MD 20872-0431.

Your application will be considered by our Membership Committee and you will hear back in a few days if you meet our qualifications.

Select the department that you served on:

Specify Other Department

Your Full Name

Nickname, Maiden Name, or other name you were known by on the department

Complete Mailing Address

Phone Number

Email - used to distribute newsletters and bulletins to you

Date of appointment to PD

Final date of service on PD

Last rank / positionheld

Last assignment

Name of last supervisor

Name of spouse or significant other

Your date of birth

* NOTE: If you retired from MCPD during the last 12 months, your first annual membership (to next 12/31) is free. Otherwise, your dues for the current year are $30.00 and may be paid on-line using PayPal at our main website page or by check sent to the address at the top of this page.

Form Updated 8/23/2023