Application

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Organization Information (to be displayed online)
Main Contact
Additional Contacts
Contact 1
Contact 2
Contact 3
Contact 4
Contact 5
Contact 6
Contact 7
Contact 8
Contact 9
Contact 10
Billing Address (if different)
Additional Information
Membership Investment
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NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
Credit Card Information

Name on Card
Security Code
Valid Through
Address
City
State
Zip
Phone
Credit Card Email Address
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Copyright Illinois Association of Fire Protection Districts.
All Rights Reserved.
1201 S. Sixth Street  |  Springfield, IL 62703
Phone: (800) 524-6620 | [email protected]