IVFA CHANGE of INFORMATION FORM

Complete this form of the necessary changes.  It will be submitted to the IVFA Central Office.

    *Denotes the information is required

* Last Name                   

* First Name            

Middle Initial

* IVFA Membership Number
OLD INFORMATION

Street Address

 City            State
 Zip Code

Home Phone                   

Department

E-mail                                                                     

NEW INFORMATION

Street Address

 City                        State Zip Code

Home Phone              

Department

E-mail                                                                                         

 

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Indiana Volunteer Firefighters Association. All rights reserved.
Revised: November 02, 2008