Membership Application - Retirees

Note:

Formerly known as Nevada Highway Patrol Association or NHPA, the Nevada Police Union (NPU) represents state police officers and public safety employees within the Nevada Department of Public Safety, Nevada Department of Wildlife, Nevada State Parks, Department of Agriculture and the Nevada System of Higher Education.

Personal Info

First Name

Last Name

Date of Birth

Personal Mobile Phone

Personal Email

Choose a password

State email addresses are not acceptable.

You must use a personal email address for your account. The union is a separate entity from your agency. We cannot accept your state work email addresses. Please enter a personal email address.

Address Line 1

Address Line 2

City

State

Zip Code

Employment Info

Agency

Social Security Number

Date Retired

Were you a Sworn employee?

Yes

No

Sworn Rank

Job Title (when you retired)

Electronic Signature for Authorization

I understand that this application in the Nevada Police Union (NPU) authorizes NPU to represent me in the matters pertaining to my employment with the State of Nevada. I hereby authorize the payroll department to deduct from my salary the membership dues in effect at this time or as modifies in the future. This authorization will remain in effect until canceled by me or by NPU. NAC281.260, as amended and adopted February 4, 2004, provides that a state employee may only cancel a payroll deduction request within the two weeks directly preceding the anniversary date when they initially requested payroll deductions.

Legal Coverage Disclaimer

To my knowledge, I am not presently named in any suits, actions, or proceedings, nor under investigation for a duty-related incident. There would be no benefit under this plan for litigation/incidents occurring before membership begins.

Privacy Policy

Your information is protected and will only be shared with the State of Nevada human resources staff for the purpose of enrollment into the Nevada Police Union. If you have any questions, please reach out to us at support@nevadapoliceunion.org. For more information about the Nevada Police Union, please visit nevadapoliceunion.org

Signature

Sign here using your mouse on a desktop or your finger/stylus on a mobile/touch screen device.

I do not wish to contribute any dues to the NPU Political Action Committee. This is not a dues refund, the money will instead remain in the NPU general fund.