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2025 National Peace Officer's Memorial Service Credential Request
** Volunteer/LEO Participant Registration Only **
** MEDIA USE THIS FORM AND MARK TRAVIS PARKER FOR COMMITTEE CONTACT **
VIP's PLEASE USE VIP REGISTRATION This form is for those that have a role in the Memorial Service
First Name
*
Middle Initial
*
Last Name
*
Date of Birth
*
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Driver's License Number
*
Driver's License State
*
Driver License Expiration Date
*
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Cell Phone Number (ONLY USE ONE NUMBER PER REGISTRATION)
*
Email Address (PLEASE USE EMAIL
ONLY ONCE FOR EACH REGISTRATION
. EACH REGISTRANT MUST USE A SEPERATE EMAIL)
*
National Memorial Committe Volunteer Approval Manager for your access - (Individual overseeing the operational component you are assisting with) APPROVAL FROM ONE OF THE MANAGERS BELOW MUST BE GRANTED PRIOR TO THE ISSUANCE OF ACCESS CREDENTIALS
*
NPOMS Armed Honor Guard - Lower Terrace Credentials assigned on May 15th at the Honor Guard Check-in on the south side. Bring Photo ID of Drivers License and Agency Credentials.
NPOMS Pipe Band Mayland Ave Walkway Credentials assigned on May 15th at the Pipe Band Check in Mayland Ave walkway. Bring Photo ID of Drivers License.
Ken Roske NPOMS Team Credentials assigned by Ken Roske
Ruben Marichalar - FOP National Memorial Committe - Site Setup
Greta Philbeck - FOP National Memorial Committee - Entertainers, National FOP Board, Program Volunteers, Vendors, Legislative Office, Special Guest
Travis Parker - FOP National Memorial Committee - Media Access Request
Glenda Lehmann - President - National FOP Auxiliary
Diane Bernhard - Executive Director - COPS (Concerns of Police Survivors)
Agency Name, Organization, or Media Outlet (If you are representing an agency or attending the service armed you must be in uniform)
Agency, Organization, Media Outlet Contact Number for Verification of Employment and/or Law Enforcement Status
IF YOU PLAN TO ATTEND THE SERVICE ARMED
, please provide a copy of your Valid Current Law Enforcement Credentials
(Only Full-Time Active Officers can be Armed at the Memorial Service)
IF YOU PLAN TO ATTEND THE SERVICE ARMED
, please provide a photo of your Driver's License. Information must be legible.