Membership Form – Stony Plain and District Crime Prevention Association

Crime Watch Association Membership Application Form

Please complete and submit the form if you want to join one of the member associations of the SPDCPA.

Required fields are indicated with a red asterisk.
You will receive a confirmation email, indicating your form responses at the primary email address you indicate below.
All submissions will be forwarded to the respective group you wish to join and someone from the group will contact you soon with further instructions, information, and payment of membership fees.

Indicate which group you wish to join:

Surname

Given Name

Number of residents in the home

Alternate Email

Home Phone

Cell Phone

Municipal Address

City/Town

Postal Code

For volunteer opportunities, when you’re representing your local association or Stony Plain and District Crime Prevention Association, additional personal information may be required such as a Criminal Record Check.

*A Criminal Record Check will be required for any members wishing to join the Executive of the Associations.

Please contact the association in your area via email for more information regarding membership fees. Email addresses are shown on the Contact page.

Declaration

By typing my name into the box below, and submitting this form, I consent to the release of personal information to the executive of the Association. I further understand and agree that, should my participation in the above mentioned document be found to be unsatisfactory by the Association or the RCMP, for cause, my membership may be terminated and all crime watch and association materials will be surrendered.

Full Name

Date

Stony Plain and District Crime Prevention Association

Crime Watch Association Membership Application Form

If the situation you wish to report is an emergency, of a serious nature, or is currently in progress, you should immediately call 911.

Report a Crime