Account Request - Parole Agent Association of California

To request an account, please fill out the following form. Once the form is submitted, we will verify the information and create an account. Please use your personal email, as you will receive notifications and updates to that email.

Last Name *
First Name *
Personal Email Address *
Phone Number *
Classification Information
Are you a BU6 dues paying member? *
What is your current Classification? *
If marked other in Classification Box above, please put classification here:
What Office/Institution do you work out of? *
What is your PERNR? *

Classification Information