ALLEGANY COUNTY FIRE SERVICE ANNUAL QUESTIONNAIRE

ALLEGANY COUNTY FIRE SERVICE ANNUAL QUESTIONNAIRE
Use "N/A": For fields that do not apply to your department, write "N/A" to indicate intentional omission.
Avoid Leaving Blanks: Leaving fields blank can lead to confusion or the perception of an incomplete form.
Department Name*
Department Email*
example@example.com
Month of Elections*
NAME, MAILING ADDRESS AND PHONE NUMBERS AND EMAILS FOR FOLLOWING:
Chief Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Email*
example@example.com
President Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Email*
example@example.com
1 Assistant

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Email*
example@example.com
Vice President *

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
2nd Assistant*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Email*
example@example.com
Secretary *

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Email*
example@example.com
3rd Assistant Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Email*
example@example.com
Treasurer Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Email*
example@example.com
REPRESENTATIVE TO COUNTY ASSOCIATION*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Email*
example@example.com
DELEGATES TO COUNTY CONVENTION *

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Email*
example@example.com
DELEGATES TO COUNTY CONVENTION (2)*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
ALTERNATES *

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
ALTERNATES (2)*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Email*
example@example.com
MEMBERS IN MILITARY SERVICE:*
Names and Dates of Service
Names and Dates of Service:*
50 YEAR MEMBERS Names:*
PLEASE RETURN WITHIN 30 DAYS AFTER YOUR DEPARTMENT'S ELECTIONS
Should be Empty:

ALLEGANY COUNTY FIRE SERVICE ANNUAL QUESTIONNAIRE

NAME, MAILING ADDRESS AND PHONE NUMBERS AND EMAILS FOR FOLLOWING:

PLEASE RETURN WITHIN 30 DAYS AFTER YOUR DEPARTMENT'S ELECTIONS