APPLICATION FOR MEMBERSHIP HUDSON MOHAWK VOLUNTEER FIREFIGHTER'S ASSOCIATION, INC.
Counties of Albany, Rensselaer, Schenectady, Saratoga Fulton, Montgomery, Warren, Washington, Columbia and Greene _____________________________________________________
To the Financial Secretary: PLEASE print legibly
Type of membership: Individual __ Fire dept/company __ Association __
Name of Fire Dept/Company/Association: _______________________
Last Name: ____________________ First Name: ___________________ MI: ____
City: _________________________State:___Zip:_____ County: _______________
Email Address: ___________________________ Hereby makes an application in the Hudson Mohawk Volunteer Firefighter's Association, Inc Organization Dues are $10.00, Associations $15.00 and Individual dues are $8.00.
Date: __________ Proposed by: __________________________
(Signature of a Presiding Officer or Secretary of Organization or signature of an Individual Member and HMVFA Member)
Make checks payable to Hudson Mohawk Volunteer Firefighter's Association, Inc.
ELIGIBILITY FOR MEMBERSHIP
Any Volunteer Fire Company, Volunteer Fire Department, Association of Volunteer or exempt Volunteer firemen and any active or exempt volunteer fireman who is serving or who may have served in any such company or department in the territory in which the operations of the Hudson Mohawk Volunteer Firefighter's Association, Inc. are authorized to be conducted.
Each member organization annually chooses two delegates to represent it at the convention of the Association. Delegates so chosen may continue as individual members by payment of annual dues of $8.00.
Send this application with remittance to the Financial Secretary of the Association. HMVFA Financial Secretary c/o Phyllis Dinkelacker 17 N. Vernon St Athens, NY 12015
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