2018 Associate Membership Application

 Associate membership Application form header 2018

Please note:                        

  1. All portions of this application must be completed.
  2. Dues are payable by April 1 of each year. Annual membership fee of $400 payable to the Fire Inspectors Association of Nova Scotia must accompany this application. See bylaws at www.fians.ns.ca for details.
  1. Completed application must be mailed to: Fire Inspectors Association of Nova Scotia, PO Box 8566   Halifax, NS B3K 5M3

Please consider this as your invoice – no other invoice will be sent. Allow 6 – 8 weeks for reply.

 

Name: ____________________________________________________________________________

 

Street: ___________________________________________________________ Suite/ Apt. #: __________

 

City/Town: ______________________________________ Postal Code: _________________

 

Phone: ______         ________                                Cell: ___________________________________                  

 

Email: ______________________________ Driver’s license master #: _______________________________

 

Local (Valley /South Shore/ Central/ Highland/ Island): __________________________________________

 

Employer: _____________________________________________________________ # Years: _________

 

Street: ________________________________________________________ Suite/ Apt. #: ______________

 

City/Town: ______________________________________  Postal Code: ________________

 

Education: High School ______ Post secondary _________ Trade _______________ # Years ______

Please sign here if you agree that we can post your work contact information on the FIANS web site for public viewing. FIANS will not be responsible for any contact initiated by disclosure of this information.

Signature

 

Event Properties

Event Date 01-01-2018
Event End Date 12-31-2018
Cut off date 12-31-2018

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