C.W.F.A. MEMBERSHIP APPLICATION  

From the office of C.W.F.A. Secretary 

 

 

___________________                                  __________________________

Company Name                                                                   Date 

 

I hereby make application for membership in the Central Western Firemen's Association for the: 

 

_______________________________               __________________________  

Department Name                                                               Town 

 

We agree to abide by the by‑laws and the constitution of the association by tendering a membership fee of one of the following: 

 

_____A.         ACTIVE MEMBER: Regularly organized fire or rescue company, and fire or rescue departments comprised of volunteer, part‑paid, paid, and to include all classes of members of such organization and this will include the Ladies' Auxiliary, who will become eligible to membership upon the payment of $50.00 per year as established in the by‑laws. 

 

_____B.         ASSOCIATE MEMBER: This member being individuals representing manufacturers and dealers in fire and rescue department supplies or firms and businesses interested in fire and rescue services. As established in the by‑laws, dues for this member are $50.00 per year. 

 

_____C.         LIFE MEMBERSHIP: An individual, firm or business entity interested in the fire and rescue service. Dues are $200.00, as established in the by‑laws. 

 

Said company of applicant is composed of _____ members, all notices of meetings and any other correspondence sent to the above company will go to the Chief. 

 

Name:_______________________________     Rank or

 

Officer___________________ (Other than Chief) 

 

Address:______________________________________________________________ 

 

City:__________________________________State:__________Zip:______________  

 

Non‑Emergency Phone:_________________________________ 

 

Chief's Name: ______________________________Phone: _____________________ 

 

Secretary's

Name:___________________________Phone:______________________  

Return to: C.W.F.A., PO. Box 111, Covington, OH 45318‑0111   937-473-3162