Future Police and Educators Association
of Grand Valley State University
Registration Form

*Name:

*Date of Birth: / /

*Class:

*Major(s):

Minor:

*Street Address:

*City:

*State:                   Zip Code:

*Daytime Phone Number:

Alternate Phone Number:

*E-mail Address:

Hometown:
City, State

Organizations you are a part of: 



Career Plans:

Would you like your information posted on the FPEA website membership page?

Yes     No

Would you like your information posted but not your e-mail address?

Yes     No

Would you like to be added to the FPEA update list to be notified when there are changed to our web site?

Yes     No