Registration: Membership Application

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Thank you for your interest in AFAUSSS.

This waiver form ( must be filled out and uploaded to this online form before we can process your application.  Please fill out the form and upload an electronic copy in the appropriate area below.

First Name:
Last Name:
Home Address:
Home Address 2:
Home City:
Home State:
Home Zip:
Home Email:
Confirm Email:
Home Phone (numbers only, no dashes):
Date of Birth:
Spouse Name:
USSS Career Date Started:
USSS Career Date Ended:
Last Secret Service Office:
Current Employer:
Current Title:
Work Address:
Work City:
Work State:
Work Zipcode:
Work Phone:
Work Fax:
Work Email:
Where do you prefer AFAUSSS messages be sent:
Work Email  Home Email  
Membership Type:
Terms & Conditions:
I certify that I meet all of the requirements of the current by-laws of AFAUSSS for membership. Membership shall be open to persons of good character who have served with due fidelity within the U.S. Secret Service for at least one year. I approve AFAUSSS checking my background.  
Membership Application Waiver:
How did you hear about AFAUSSS?:
What do you hope to gain from membership?:
By submitting this online form, I understand and agree that AFAUSSS will have my contact details for the purpose of processing my information and ensuring full participation. For complete privacy policy, click here.
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