Chapter Interest Form
Please fill out the form below if you have interest in starting a PFB chapter at your fire department. We host 3 meetings per month that explain what it looks like to become a chapter. You will have the option to schedule one on this form or schedule one later. Please follow the directions on the email that you will receive once this form is completed. This must be completed by a member of the fire department or fire district.
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First Name
*
Last Name
*
Phone
*
Email
*
Fire Department Name
*
Fire Department Location
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Northern Mariana Islands
Puerto Rico
U.S. Virgin Islands
Canada
County
What type of Fire Department?
*
Career
Combination
Part Time
Volunteer
Why do you want to become a chapter?
*
Would you like to pick from our available meeting dates?
*
Yes
Book Later
Schedule here:
https://www.signupgenius.com/go/10C084EAEAC2FA3F5C52-49147908-prospective
Submit
Should be Empty: