"Celebrating the Past, Embracing the Present, Envisioning the Future"

MEMBERSHIP PAGE

Read the Bylaws - Membership

Benefits of Membership

 

ON-LINE Membership REGISTRATION FORM

(Click Here to use printed form.)

 

Membership is renewable after January 1st, each year -- join or renew now !

  Please Enter Your Personal Information:  
  First Name
  Last Name
  Employer or Affiliation (or Individual)
  Position or Title  (if any)

  Mailing Address

   (please include city/state/zip)
  Email address
  Contact Phone Number

                                                  *All information is required and will not be sold.

  Allow entry into membership directory --  Yes    No    (*Directory will be published.)

 

  Please choose the type of membership that is right for you:

     ( *50% can be designated to benefit a member group )

 

   Individual Membership = $20.00  

 

   First Responder Agency = $50.00  [ Fire Departments, Rescue Squads, Law Enforcement, etc. ]

 

   Corporate/Business Partner = ( Choose level of support )

                 Patron at $300.00 or more

                     Benefactor at $200.00

                        Supporter  at  $100.00

 

                

                 Designate 50% of my membership dues to this group -

                          (Click on down-arrow)

              

                 OR, 

                 *Designate 100% of my membership dues to VFLSC (statewide coalition).

 

        Payment method: Online with PayPal      Check       Money Order

                                                 (*Pay on-line below)

                                                                                                        [ Back to the Top ]

 

    *Make check or money order payable to "Virginia Fire & Life Safety Coalition" and send it to:

 

                                      VFLSC Treasurer - Curtis Stilwell

                        11508 Parkgate Drive, Nokesville, Virginia  20181

                       703-228-3600 ext.9295      cstilwell@arlingtonva.us

                                                                                                  

   Please submit any comments or questions you may have here:
 
  ( Click here to submit your membership registration. )  

 

 

 

 

  *Next, you will see a confirmation page with your information -- please print this page for your records.

 

  *Then, click on "Return to the form" or the "Back" button if you wish to pay online using PayPal  [below].

 

                                            THANK YOU VERY MUCH !  

 

  For additional information, contact:

                   

Secretary - Sandy Bailey

New Kent Fire & Rescue

4315 N. Courthouse Rd,

 Providence Forge, VA 23140

804-869-4311

sbailey@co.newkent.state.va.us

 

 

        

President - J.D. Jenkins

VDFP/VFMA Public Education Coordinator

25 Wooten Road, Sandston, VA 23150

804-921-6631 (cell)

804-249-4177 (work)

johnd.jenkins@vdfp.virginia.gov

 

 ($20.00 ) Click here to pay online with PayPal for: Individual Membership - 1 year.

 ($50.00 ) Click here to pay online with PayPal for: First Responder Agency - 1 year.

  Corporate/Business Partners - Please choose your level of support, and mail a company check.

 

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