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Liberal Firefighters Association of Broward County - Membership Application
Member Name
*
Address
*
Home Phone
*
Cell Phone
*
Email Address
*
Membership Dues (select one)
*
Membership Dues (select one)
A
Bi-weekly $5.50
B
Monthly $12.00
C
Quarterly $36.00
D
Yearly $143.00
Are you interested in becoming actively involved? (check one)
*
Are you interested in becoming actively involved? (check one)
Yes, I would like to become actively involved and have the time to devote
Yes, I would like to become actively involved and have the time to devote
No, I do not wish to be actively involved.
If you would like to be actively involved and have time to devote would you like to hold a position? (check one)
If you would like to be actively involved and have time to devote would you like to hold a position? (check one)
YES
NO
By signing this application, you agree to uphold the standards of this organization and adhere to its bylaws. Your affiliation is strictly voluntary and can be terminated without cause by either party.
Member Signature
*
Signature
Date Signed
*
Submit