2012  CWFA INVOICE

Central Western Firemen’s Association Notice of Annual Dues

Your annual dues pay for CWFA administration, related publications, fire training, newsletter publications and mailings. Support your Association by paying your annual dues. Please fill-in all of the blanks and return the completed form with your payment. Please make check payable to the Central Western Firemen’s Association.

Dues Postmarked                                        Mail to: CWFA Secretary

Before March 1^st                                                       P.O. Box 101

$50.00                                                            Covington, Ohio 45318

                                                                                    1-937-473-3465   

March 1st-31st                                              We have _____ members in this Department                 

$55.00                                                           

April 1st-30th                                                            ____________________________________

$60.00                                                                        Please print name of organization

May 1st-31st                                                  ____________________________________

$65.00                                                                        Address

After June 1^st                                                            _________________________________

$70.00                                                                        County

_____________________________________

City, State, Zip Code

.

Department Information

DEPARTMENT   E-MAIL   ADDRESS     _______________________________                                                                                  

Chief’s Name__________________________________________

Address _______________________________________________

City, State, Zip Code_____________________________________

Department Phone_______________________________________

Other Phone Contact_____________________________________

Secretary’s Name________________________________________

Address________________________________________________

City, State, Zip Code______________________________________

Secretary’s E-Mail address_________________________________

                                                                                                                    Thank You,    2012 CWFA