MSFA LOGO

MSFA Convention Registration

MARYLAND STATE FIREMEN'S ASSOCIATION

Representing the Volunteer Fire, Rescue, and Emergency Medical Services Personnel

Electronic 2014 C R E D E N T I A L S F O R M

 

Pressing Submit Will Save your information Directly to MSFA without further submission

This Form should be completed by the Company President or Secretary

To the Secretary of the Maryland State Firemen's Association: At the Regular Company Meeting of:,

,Inc.,

in County, Maryland, the delegates and alternates listed below were elected or appointed to represent the company during the next year and at the next Annual Convention of the MSFA:

OFFICERS

President        : President's Email:

Vice President:    VP Email           :

Secretary        : Secretary Email   :

Treasurer        : Treasurer Email   :

Chief              : Chief's Email        :

Chaplain        : Chaplain's Email    :

Delegates

Chair            : Chair Email            :

Delegate2     : Delegate2's Email   :

Delegate3    : Delegate3's Email   :

Delegate4    : Delegate4's Email    :

Delegate5    : Delegate5's Email   :

Alternates

Alternate1   : Alternate1's Email   :

Alternate2   : Alternate2's Email   :

Alternate3   : Alternate3's Email   :

Alternate4   : Alternate4's Email     :

Alternate5   : Alternate5's Email    :

Full Name of Company :

Mailing address of Company :

Town :    State :     Zip :

Street Address if Different:

Phone :    Fax :

Web Site :

Date :

Person Completing Form :    Completer's Email :

Title / rank of person completing form President, Secretary,etc.  : Completer's Phone :

Press Submit Query to Save and record your information or you may print this form out and submit it as below or print out the submission page which follows:

Pressing Submit Will Save your information Directly to MSFA without further submission.

Please Enter all 5 Letters and Numbers at right :  

Doyle Cox Secretary MSFA

or Fax to: 410-822-8508

or Mail to: Doyle Cox

MSFA Secretary

29132 Superior Circle

Easton, MD 21601

We would suggest you do more than one and keep a copy for your records