FIRE MARSHAL’S 2007 MEMBERSHIP APPLICATION FORM
Please provide the following information. Complete a separate application form for each individual. Again this year we offer you the option to pay for the
membership and training as one fee.

Full Name:
Title:
Name of Organization:
Address:
City:
State:
Postal Code:
Day Phone:
Ext:
Fax:
Email Address:


Select Your Membership Level:

 Class A Member ($25.00 per year) - Any official who heads the Fire Department, Fire Prevention Bureau, or Building Department of any city, county, state or federal jurisdiction.
Class B Member ($10.00 per year) - Any member of an agency who has a Class “A” member.
Class S Member ($15.00 per year) - Any person who is associated with an agency and has interest in the functions of the Association, but will not realize any profitable gain by the actions of the Association.
Class P Member - ($50.00 per year) - Any person engaged in private industry or enterprise who can benefit the Association through knowledge of their industry and may realize gain from actions of the Association.
TRAINING CLASS FEES ($125.00) Please include my 5 training classes with my membership application.

Payment:
If you prefer to pay by check, please download the member application here

Credit Card No:
Expiration Date:
mmyy
Name on Card:
Type: