Hampton Professional FF Association Local 2450

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

APPLICATION FOR AFFILIATION

Email *

Please check the appropriate box *

Initial affiliation - includes $25.00 registration fee and first month dues $36.08 (total $61.08)

Reinstatement - include $25.00 and back dues (contact Treasurer for amount owed)

Retirement affiliation

Transfer from another IAFF Local (may have a transfer fee)

Date *

Name *

Birthday *

Mailing Address *

Telephone Number (Cell and/or Home)

Email Address (Do Not Use City Email Address) *

Do you prefer text messages or emails concerning Local 2450 information

Text Message

Clear selection

Bank Name - Account has to be set up with Bayport Credit Union for automatic payment of dues or your personal bank or account has to be paid in full for the year. Verification is needed. *

How will you be paying your dues? *

Yearly $432.97

Monthly $36.08

Biweekly (each City paycheck) $16.65

IAFF number (if reinstating)

Station and Shift Assignment *

NOTE: You will be affiliated the first month after you submit your application. The IAFF will issue a membership card and it will be mailed to the address listed above. You will not be able to obtain Professional Firefighter License Plates until you receive your membership card.

An invoice will be sent to the email address that is provided above. Please pay the invoice by electronic transfer or mail a check to: P.O. Box 3149 Hampton, VA 23663. Membership will not be in effect until payment is received. Any questions or comments please contact Secretary / Treasurer Jami Salvio 757-508-1736. You may also write any questions you may have below.

Untitled Title

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms