Latino Officers Association Florida Chapter Application form. www.loafla.org   P.O. Box 44-0581 Miami, Fl 33144 1.877.466.8741 The mission of the L.O.A is to promote tolerance toward the understanding of the Latino culture in the law enforcement community and create a strong bond between the Latino community and agencies across Florida. It also aggressively seeks to increase the number of Latino Officers in Florida. If you are interested in starting your own LOA-FLA chapter within the confines of your agency fill out the application Name:___________________________________________Date:____________________ Address:_______________________________________ Phone:______________________ Cell phone:___________________________________ E-mail:_________________________ Agency:________________________ Rank:_____________________Shield#___________ Years of services:__________Amount of members:_______________ Are you currently the subject of an on going Internal Affairs Investigation____yes ____No please provide us with a brief summary as to why you want to start a LOA-FLA chapter:__ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Failure in compliance with the mission statement may result in removal of membership: Signature:_____________________________________________________________________ In God We Trust -------------------------------------------------- For official uses only Form number 08-02 online application Region approval: Central____ Gulf___ South_____ ______________________________________________________________________________