Oklahoma Corrections Professionals
(405) 517 5990
info@o-c-p.org
Each member of the Board is an
Application for Membership
Identifying Information
First Name:
Middle Initial:
Last Name:
Date of Birth:
Employee ID or Full SSN
- Without this information your voluntary payroll deduction cannot be processed. -
Agency
Contact Information
Home Address (Mailing Address)
City
State
Zip Code
Facility or Work Location
Position
Personal Phone Number
Personal Email Address:
Authorization
By submitting this form, I hereby authorize the State of Oklahoma to deduct from my pay the amount shown below required to purchase dues in Oklahoma Corrections Professionals, subject to my right to revoke this order by written notice to my employer.
Dues (Cost of Membership)
$15 per month
By electronically signing this application, I authorize the release of my home address and contact information to Oklahoma Corrections Professionals.
Electronic Signature
Last Four Digits of SSN
Please Verify Your Personal Email Address
Were you referred by a current member of OCP? If so, who?
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