Membership Application

Name: ______________________________________ Title: _____________________

Agency: ________________________________________ Fleet Size: ____________

Address (Office): _______________________________________________________

City: _________________________________ State: _____ Zip: _______________

Phone: ______________ Fax: ________________ E-Mail: _____________________

Address (Home): _________________________________________________________

City: __________________________________ State: _____ Zip: ______________

Sponsor: ________________________________________________________________

Comments: _______________________________________________________________

_________________________________________________________________________

Please send mail to my (check one): ( ) Home ( ) Work address

Membership Category (check one):
( ) Retired ($15)
( ) Regular (Fleet) ($45)
( ) Sustaining (Vendor) - NEW ($145)
( ) Sustaining (Vendor) - Renewal ($65)
 

Print this form, complete it and mail to:
Public Fleet Supervisors Association
Attention: Membership Chair
849 East Stanley Boulevard #412
Livermore, CA  94550-4008

Do not send any money with this application.
Dues are payable upon election to membership.
See the PFSA Application Addendum for more information.

Thank you for your interest in joining the Public Fleet Supervisors Association!