Membership Application

Are You a New Applicant or Are You Renewing Your Membership?(Required)

Renewing My Existing Membership

Applying For New Membership

Membership Type(Required)

Name(Required)

Group/Organization/Fire Department Name(Required)

Group/Organization/Fire Department Contact Name(Required)

Email(Required)

Home/Mobile Phone(Required)

Mobile/Work Phone

Group/Organization/Fire Department Phone(Required)

Preferred Phone for Contact

Home/Mobile Phone

Mobile/Work Phone

Address(Required)

Group/Organization/Fire Department Address(Required)

Fire Department Affiliation, If Any:

Would You Like to Register Your Antique Apparatus?

Yes

Antique Apparatus Registry

If a piece of firefighting apparatus 25 years old or more, is owned by the applicant, please give complete information that is requested below. (Ownership of apparatus is NOT required for membership in the O.D.H.F.S.)

Year

Make

Type

Pump Type

GPM

Tank Size

Manufacturers Model

Manufacturers Serial Number

Previous Owners & History of Apparatus

Have an Additional Apparatus You'd Like to Add?

Yes

Additional Unit

Year

Make

Type

Pump Type

GPM

Tank Size

Manufacturers Model

Manufacturers Serial Number

Previous Owners & History of Apparatus

Membership Payment

Online Payment: Use our safe and secure online form for convenient dues submission. Choose the 'Pay Online' option for fast and easy credit card payments. Please note, a $1 service fee is added to all online transactions to cover credit card processing costs.

Paying by Check: If you prefer, select 'Pay by Check' and mail your check to: O.D.H.F.S., P.O. Box 4196, Chester, VA 23831. When paying by check, only the $20 membership fee is required, without any additional service fees.

Keep your membership active by choosing the payment method that suits you best!

I would like to(Required)

Pay Securely Online with Credit Card

Pay by Check

Would You Like to Include a Donation With Your Membership?

Yes

How Much Would You Like to Donate?(Required)

Total

Payment Method

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Old Dominion

Historical Fire Society

Antique Apparatus Registry

Additional Unit

Membership Payment

Mailing Address

Physical Address

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