LAMSFA 50 Year Member's Registration - Maryland State Firefighter's Association

In recognition of 50 continuous years in a Maryland Auxiliary, awarded in 5 year increments. It is very important that the Name & Auxiliary information is carefully entered. Certificate(s) will be printed EXACTLY as the information has been supplied.

Your Information
Person Completing Form*
First Last
Completer's Email*
Enter Email Confirm Email
Completer's Phone*
Official Auxiliary Name*
1st Member's Information
Name*
First Last
Address
Street Address City State ZIP Code
Phone
Date Joined*
MM slash DD slash YYYY
2nd Member's Information (Optional)
Additional fields will appear if you begin to enter a second individual's name.
Name
First Last
Address
Street Address City State ZIP Code
Phone
Date Joined*
MM slash DD slash YYYY
3rd Member's Information (Optional)
Additional fields will appear if you begin to enter a third individual's name.
Name
First Last
Address
Street Address City State / Province / Region ZIP / Postal Code
Phone
Date Joined*
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

Maryland State

FIREFIGHTERS ASSOCIATION

LAMSFA 50 Year Member’s Registration

Your Information

1st Member's Information

2nd Member's Information (Optional)

3rd Member's Information (Optional)

Partners of the MSFA

Maryland State

Firefighters Association

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