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                                                                               FRATERNAL ORDER OF POLICE

                                                                               PORTAGE COUNTY LODGE NO. 70 

                                                                             POST OFFICE BOX #122, RAVENNA, OH 44266 

Date: ___________ 

I, the undersigned, respectfully request to become a member of the Fraternal Order of Police, Portage County Lodge No. 70.  I herewith certify that I am gainfully employed as fulltime LAW ENFORCEMENT OFFICER with a Federal State (  )  County (  ) Municipal (  ) Law Enforcement Agency. I further certify that if I am accepted as a member of the Lodge, I will faithfully perform my duties as a Law Enforcement Officer and will do nothing willfully, or maliciously to bring discredit or dishonor upon the FRATERNAL ORDER OF POLICE, PORTAGE COUNTY LODGE NO. 70, or MEMBERS THEREOF.

	Signature of Applicant

Brother/Sister:_________________________________

Active Member Print Name

	Active Member Signature

Brother/Sister:_________________________________________________

Active Member Signature

Active  Member Print Name    

(Please type or Print in BLOCK letters)  

Name                                                                       Address______________:

Portage County Lodge #70

PO Box 122, Ravenna, Ohio 44266-0122                                                   S E A L

Obligation

I, _____________________, in the presence of the Creator of the Universe and the members of the Fraternal Order of Police here witnessing, do most solemnly and sincerely promise and swear, that I will to the best of my ability to comply with all the laws and rules of this Order; that I will recognize the authority of my legally elected officers and obey all orders there from not in conflict with my religious or political views, or my rights as an American citizen; that I will not cheat, wrong, or defraud this Order, or any member  thereof or permit the same to be done if in my power to prevent it; that I will at all times aid and assist a worthy Brother (or Sister) in sickness or distress, so far as it lies in my power to do so; that I will not divulge any of the secrets of this Order to any one not entitled to receive them.  To all of which I most solemnly and sincerely promise and swear.  Should I violate this, my solemn oath or obligation, I hereby consent to be expelled from the Order.

_______________________________________

Signature

_______________________________________                                _____________

Witness                                                                                                          Date

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