DUtchess County Volunteer Firemen's Association

 

NAME___________________________________________________________________

ADDRESS________________________________________________________________

TOWN____________________________________________________________________

E-MAIL ADDRESS_________________________________________________________

FIRE DEPARTMENT_______________________________________________________

PROPOSED BY _____________________________________________________________

SIGNATURE_______________________________________________________________

REMIT $5.00 Member   $ 10.00 Company

PLEASE FORWARD  

DCVFA

392 Creek Road

Poughkeepsie, Ny, 12601