MEMBERSHIP APPLICATION AND RENEWAL FORM
PLEASE ENTER TODAY'S DATE ____/____/20____
PLEASE INDICATE TYPE OF MEMBERSHIP: ____ REGULAR ____ VENDOR
COMPANY/ORGANIZATION:
MAILING ADDRESS (CITY, STATE, ZIP CODE):
1. REPRESENTATIVE (LAST, FIRST, MIDDLE)
TITLE:
BUSINESS PHONE: ( __ __ __ ) __ __ __ - __ __ __ __, FAX: ( __ __ __ ) __ __ __ - __ __ __ __
EMAIL ADDRESS:
2. REPRESENTATIVE (LAST, FIRST, MIDDLE)
TITLE:
BUSINESS PHONE: ( __ __ __ ) __ __ __ - __ __ __ __, FAX: ( __ __ __ ) __ __ __ - __ __ __ __
3. REPRESENTATIVE (LAST, FIRST, MIDDLE)
TITLE:
BUSINESS PHONE: ( __ __ __ ) __ __ __ - __ __ __ __, FAX: ( __ __ __ ) __ __ __ - __ __ __ __
SPONSORED BY:

About The Membership Application and Renewal Form

Annual dues cover a maximum of three representatives from each organization. Additional members can be added to the list for $10.00 each. Dues are for the fiscal year January 1 through December 31. If dues are not in by the first day of July, (membership renewals only) your membership will expire. Annual dues are $35.00 for regular membership and $50.00 for Associate Membership.

Please mail this application and your check made payable to CFMA, to the following address:

Colorado Fire Mechanics Association
P.O. Box 17961
Denver, Colorado 80217