Application

for

Reciprocal Membership

Membership is requested into: _________________________________________________________________

(Please indicate which organization you are applying to.)

Date of Application: _____________________

Name: __________________________________ Patrol Affiliation: _________________________________

Address: ______________________________________________ Social Security Number: _____________________

City:________________________________________State: _________________Zip:______________

Telephone: ____________________________NSP or PSPA Certified Number:_____________________

Date you completed the components of the discipline you are applying from: ____________________

The opportunity to apply to either organization through the reciprocal agreement between the NSP and the PSPA is a result of good working relationship between us. Both organizations rely on their members to support the philosophies and standards that have made these two programs a sought after accomplishment. Examiners and officers of both organizations are members who believe in and are willing to commit their time and energies into strengthening their programs. A requirement of this application is a letter of introduction outlining what your commitment to the organization you are applying to will be, and how you plan on becoming involved to help us to preserve and strengthen the program.

To be eligible applicants must meet the following requirements:

1. The applicant must be a member in good standing in the organization they are applying from.
2. The applicant must be Certified in one discipline for at least one year.
3. Must complete any non reciprocal requirements.
4. When applying to PSPA the applicant must prove part time earnings for three years or full time earnings for one year to satisfy the Association bylaws.
5. When applying to the PSPA please include a letter of recommendation from a member of the PSPA.
6. When applying to the NSP Certified program you must include two letters of recommendation. One from the current PSPA president and the other from your patrol director.
7. Forward this application to the appropriate organizational person.

NSP: Karl Johnson, 297 Granite St., Quincy, MA 02169-4931, 617-472-3193 johnson.building@verizon.net

PSPA: Emily Hinman, 17 Woldbrook Dr., Windham, ME, 04062 emily@pspa.org