NSVFA Enrollment Form

Instructions

Choose one of the two membership options below. You will be asked on page two to enter the number of members or additional newspaper subscriptions you wish to add.

Additional subscriptions may be used by board members, retired members, etc... The rate for additional newspaper subscriptions is $6 for 100% Department memberships and $10 for Member Only Department memberships.

After completing the enrollment form, we will setup your membership and contact you with the next steps for entering contact information for your members' names, if they are not on file with us already.

Select An Option

Member Dept $110.00 Annually + Price of Level Selected (Price Range: $20.00 - $20.00 Annually)

Select Level

“Member Dept.” Only Membership = Enrollment of only the Fire Chief and selected members chosen by the department for enrollment as NSVFA members. ANNUAL DUES—$110.00 which includes the Fire Chief. After the Department/Fire Chief dues are paid, additional members may be added @ $20.00 each.

Included as part of the $110.00 per department/chief dues is one copy of the Nebraska Firefighter mailed to the address listed for the fire chief beginning with the October issue and concluding with the September issue the following year. Any added members will also receive a monthly subscription. Members must be enrolled by September 1 to receive their October issue.

Additional subscriptions for non-NSVFA members ie. Retired members, Board members are welcome at a cost of $10.00 per subscription as long as the payment is submitted with the dues.

100% Dept $20.00 Annually + Price of Level Selected (Price Range: $0.00 - $7.00 Annually)

Select Level

100% Department Membership = Enrollment of ALL of a Department’s members as NSVFA members.
ANNUAL DUES—$20.00 per member including the Fire Chief.

Included as part of the $20.00 per member dues is $6.00 for a one year subscription to the Nebraska Firefighter beginning with the October issue and concluding with the September issue the following year. Members must be enrolled by September 1 to receive their October issue.

Additional subscriptions for non-NSVFA members ie. Retired members, Board members are welcome at a cost of $6.00 per subscription as long as the payment is submitted with the dues.

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

E-mail

Family NameDepartment Name

Please select a valid membership option and fee item if exist

Nebraska State Volunteer Firefighters Association

521 First Street, PO Box 10 Milford, NE 68405
P: 402-761-2211 | Fax: 402.761.2224 | Email us

Fire and Rescue Serving the Heartland

NSVFA Enrollment Form

Nebraska State Volunteer Firefighters Association

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