MAFPD Membership
Missouri Association of Fire Protection District membership form
Fire District Name *
Your answer
Mailing Address *
Your answer
City *
Your answer
Zip *
Your answer
Fire District Email *
Your answer
Type of MAFPD Memberships
Membership *
Does your Fire District have a sale Tax? *
Fee Structure
Amount Due *
The amount of your dues, which you need to return with this form, is shown on the chart on the previous page. If you have a sales tax, remember to add the sales tax surcharge of $300 to the total due.
Fire Chief Name *
Your answer
Fire Chief Email address *
Your answer
Fire Chief Cell Number
Your answer
Board President Name *
Your answer
Board President Email Address
Your answer
Board President Cell Number
Your answer
Board Member Name *
Your answer
Board Member Email Address
Your answer
Board Member Name
Your answer
Board Member Email Address
Your answer
Board Member Name
Your answer
Board Member Email Address
Your answer
Board Member Name
Your answer
Board Member Email Address
Your answer
Fire District Attorney Name
Your answer
Attorney Email Address
Your answer
Attorney Cell Number
Your answer
Do you have any suggestions for topics to be covered at our annual conference, or in our educational programs? If so, please describe below
Your answer
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