APPLICATION FOR LIFE MEMBERSHIP

Please read the following excerpt from the IAFC Constitution and By-Laws and complete the form below:

LIFE MEMBERSHIP. Life membership shall include Active and Associate members who have retired from the Fire Service, provided the have been members of the Association continuously for ten(10) years and further provided they are not identified with fire protection commercially, or have become a Chief, Assistant Chief, Commissioner, Fire Marshal, or any other of the services that would make them eligible for either Active or Associate membership. Life membership may be obtained by application to and certification from the Executive Director. Only Active Life members shall be entitled to vote on all matters unless prohibited by the Constitution, but shall not be entitled to hold elective office or serve on the Board of Directors. Life members shall not pay annual dues. (Article II, Section 4C, IAFC Constitution & Bylaws).

I hereby make application for Life Membership and certify that I have read the above section of the Constitution and Bylaws. I further certify that I meet all the requirements needed to comply with the article printed on this form.

_____________________ ___________________________

Retirement date Signature

Member #______________ Division _______

RETIREMENT ADDRESS TO RECEIVE FUTURE MAILINGS:

NAME

TITLE

ADDRESS

CITY/STATE/ZIP

PHONE/FAX NUMBERS ____________________________________________

If you wish to continue a Subscription for IAFC On Scene, the cost is $30.00 annually.

Return this form to:

IAFC Member Services

4025 Fair Ridge Drive

Fairfax, VA 22033