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Application for Membership

For membership to the Westchester County Volunteer Firefighter's Association please fill out the online application below or download and print the application.

 

The below named, a Volunteer Firefighter, Active or Exempt, Junior Member, or a member of a Recognized Volunteer Fire Related Organization in a Westchester Fire Company, Department or Association, does HEREBY Apply for Membership in the WESTCHESTER COUNTY VOLUNTEER FIREFIGHTER’S ASSOCIATION, INC. and attests to the following as being correct.

Required   Indicates Required Field
Name of Applicant: Required
Mailing Address:
Street Address | City | Town or Village | State | Zip Code
Required
Home Phone Number:
Cell Phone Number:
Date of Birth: Required
Email Address: Required
Status: Required
Name of Fire Company, Department, Assn. or Recognized Volunteer Fire Related Organization: Required
Date you joined: Required
Total years in Volunteer Fire or Related Fire Service: Required
Proof of qualification – please list an Officer's name and phone number below (Junior Members must also attach a letter from a Parent or Guardian giving permission to join.)
Officers Name:
Officers Phone Number:
By signing my electronic signature below, I signify that I have applied for the membership to the Westchester County Volunteer Firefighter's Association.
Your Electronic Signature: Required
An application fee of $10.00 must accompany this Application. Thereafter, dues in the amount of $10.00 shall be payable on a yearly basis commencing in the 1st Quarter of the fiscal year.




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Westchester County Volunteer
Firefighter's Association

65 6th Street
Verplanck, NY 10996
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