Department Membership Renewals

NOTICE
By-laws Article 1 Section 2
The annual dues of each Company or department shall be five dollars and no cents ($5.00) for each member on their books in good standing, and shall be forwarded to the State Association Secretary on or before August 1st each year. In the event of non-payment of dues, the Company or Department shall be denied the privilege of representation in the annual or special meetings of the Association.

Department or Company Name
Address*
Street Address Address Line 2 City State ZIP Code
Fee per member:*
Price: $5.00
Number of Members*
Please enter a number greater than or equal to 10.
Total
$0.00
This payment to be applied for 7/01/2019– 6/30/2020
We're updating our records
Please provide current contact information (or business cards) so we can reach key individuals should we have questions about membership or other VSFA business. Information provided is for the purposes of VSFA business and will not be shared.
Chief or President’s Name*
Role First Last
Email*
Station Phone*
Cell Phone*
Secretary’s Name
First Last
Secretary's Email
Secretary's Cell Phone
Treasurer’s Name
First Last
Treasurer's Email
Treasurer's Cell Phone
Which individual is filling out this form?
Your name
Your Email
Payment
Total
$0.00
Payment details

Card Number

Expiry (MM/YY)

Card Code

Card Postal Code
Name
This field is for validation purposes and should be left unchanged.

We're updating our records

Payment