New England Association of Fire Marshals

Membership Application

Fill out the information below and print. Forward with $25.00 Annual Fee to N.E.A.F.M, 90 Crystal Drive Rocky Hill, CT 06067. Fiscal year starts January 1st.

Please provide the following contact information:

First Name
Last Name
Middle Initial
Title
Organization
Mailing Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail

Date of Application:

-- mm/dd/yy

 

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