Application/Renewal If you are renewing and have NO changes, you may use this form: Renewal No Changes. CompanyThis field is for validation purposes and should be left unchanged.New New Reffered ByRenewal Renewal Applicant's Name Applicant’s Name First Middle Last Do not add Do not add my information to the website Membership List (www.gappi.org) Member Information Agency NameAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneCellFaxEmail Website: Membership Level & Annual Fee Please Select only oneActive QuantityLimited to Private Detectives and Security Officers Licensed or Registered in the State of Georgia who are in good standing with the Georgia State Licensing Board. Price: $110.00 Quantity Associate QuantityAvailable to any person who is in the field of investigations or security but NOT licensed in the State of Georgia. Price: $110.00 Quantity Retired QuantityLimited to individuals who are retired from the private detective or security field, GAPPI member for 5 years, and licensed in GA for 5 years. Price: $110.00 Quantity Corporate QuantityProvides memberships for up to 3 (active or associate) employees of the same company. Additional corporate members beyond the first 3 are $75 each. Price: $220.00 Quantity Over 3 Employees Select if you are adding more then 3 employees Product Name Quantity Price: $75.00 Quantity Total $0.00 Student QuantityAvailable for individuals who are enrolled in a private detective, security, or criminal justice training program. After one year, student must renew as an Active or Associate Member. Price: $55.00 Quantity Student Members Instructor NameInstitution Corporate Members Name1. Name 1 active Active 1 Associate Associate 2. 2 active Active 2 accociate Associate 3. 3 active Active 3 accociate Associate 4. 4 active Active 4 accociate Associate 5. 5 active Active 5 accociate Associate State License Information Agency License #Type Detective Securtiy Both Employee License #Type Weapon Non-weapon Instructor License #Type Classroom Firearm Both Has the licensing board in any state ever taken action against you? (suspended, revoked, censored or withdrawn, consent order) If yes, please attach a written explanation.Untitled Yes No Committee Interest Benefits Communications Legislative Benevolence Education/Training Membership Services You Provide Indicate a Maximum of Five (5)Detective Arson Investigations Asset Investigations Aviation Investigations Accident Reconstruction Background Checks Child Abuse/Custody Investigations Civil Investigations Construction Investigations Corporate Investigations Computer Crimes Investigations Crime Scene Investigations Criminal Investigations Debugging Divorce Investigations DUI Investigations Document Examinations Due Diligence Investigations Executive Protection Fingerprint Analysis Firearm/Ballistics Investigations Fraud Investigations Homicide Investigations Handwriting Analysis Industrial Accident Investigations Infidelity Investigations Intellectual Property Investigations Interviews & Interrogation Insurance Fraud Investigations Maritime Investigations Medical & Malpractice Investigations Missing Persons Investigations Mystery Shoppers Narcotics Investigations Personal Injury Investigations Polygraph Examinations Pre-Employment Screening Investigations Prenuptial Determinations Process Service Product Liability Investigations Property & Real Estate Invest. Security/Property Protection Sex Crime Investigations Skip Tracing & Locates Technology Investigations Theft Investigations Undercover Operations Security Guard & Patrol Armored Car/ Courier Executive Protection Detention Facility Security Consulting Payment Options Total $0.00 Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Expiration Date Security Code Cardholder Name Complete Mailing AddressFull Name Statement of Intent I hereby apply for membership in GAPPI and agree to abide by the GAPPI Constitution, Bylaws and Code of Ethics. If applying as an active member, I hereby attest that I am licensed and in good standing with all applicable state licensing agencies. I attest that the information provided on this application is true and correct and understand that submitting false information will result in the revocation of my membership and loss of any fees. I understand, unless otherwise indicated, the information on this application will be available for publication and I agree to fully and completely hold harmless all parties in the release and use of such information.Full NameDate MM slash DD slash YYYY CAPTCHA
