2024 MCSA Corporate Partnership Request

Completion of this form is NOT confirmation of partnership. It is an indication of your company's intent to join with the Major County Sheriffs of America as a 2024 Corporate Partner and/or express interest in joining the email list to receive advance information about our 2025 partnerships.

No partnership is secured until the customized partnership contract provided by MCSA is signed by an authorized representative of your company and countersigned by the MCSA Executive Director *AND* your partnership dues are paid in full. Failure to sign and return the agreement and make payment by December 31, 2023 will result in forfeiture of your reserved slot so it can be offered to the next company on our waiting list.

Company Name *

Business Address *

Address Line 2

City *

State *

Zip Code *

Company Point of Contact

First Name *

Last Name *

Title *

Email Address *

Preferred Phone Number *

Additional Phone Number (optional)

Are you a current MCSA Partner *

Yes

No

What is your current level of partnership?If you are unsure, please check here to confirm. *

Has your company ever partnered with MCSA in the past? *

Yes

No

REMINDER: Deputy Level is a one-time only trial partnership. As a current or previous partner, you are not eligible to partner with us at the Deputy Level. Choosing that level on this form will result in the forefeiture of your place in the queue.