South Carolina Law Enforcement Victim Advocate Association 2023 Membership ApplicationMember Year: December 01 - November 30 Name * First Name Last Name Agency * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Cell Phone (###) ### #### Work Phone (###) ### #### Email * Membership Category (Please select one) * Member ($30) – Law Enforcement Advocates from Local, State and Federal Agencies Associate Member ($35) – Representing all other facets of victim services or allied agencies Payment * Mail payment to: Marisa Capers SCLEVA Treasurer Lexington Medical Center Department of Public Safety 115 W. Hospital Drive W. Columbia, SC 29169 I will mail a check or money order payable to SCLEVA. Additional comments: Thank you! You have successfully submitted your application to SCLEVA.