Please read instructions first. Completed, dated and signed forms with support documentation attached should be forwarded to:
Dept. 110
International Military Police Federation
865 United Nations Plaza
New York, N.Y. 10017
United States of America
| RECENT PHOTO (Please sign on reverse side)
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FAMILY NAME: ________________________________________________________
OTHER NAMES: ________________________________________________________
RANK: _____________________________________________
SERVICE: ___________________________________________
STATUS (Active/Retired): _______________________________
DATE OF BIRTH: ____________________________________
COUNTRY OF BIRTH: ________________________________
PRESENT NATIONALITY: _____________________________
SEX (Male/Female): ___________________________________
MARITAL STATUS: ___________________________________
CURRENT PROFESSION: _________________________________________________
ADDRESS: ______________________________________________________________
________________________________________________________________________
________________________________________________________________________
MOTHER TONGUE: _______________________________________________________
OTHER LANGUAGES: _____________________________________________________
OTHER ORGANIZATIONS OR ASSOCIATIONS OF WHICH YOU ARE A MEMBER:
_________________________________________________________________________
_________________________________________________________________________
Have you ever been arrested and/or convicted of a crime? / / Yes / / No
I certify that statements made in the foregoing applications are true, complete and
correct. I have read, understood and accept the IMPFV principles instructions and co
conditions of acceptance. I understand that any misrepresentation or omission made on the
V-1 form renders my candidature liable to reconsideration or immediate withdrawal.
I hereby request consideration for acceptance into IMPF Dept. 110. I have read and understand the above conditions, stipulations and the instructions to IMPF volunteers.
Signed_____________________________ Dated:____________________