UPDATE CONTACT INFORMATION
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We are developing a more detailed database of our membership.
Please take the time to fill in all the fields on this form.
This additional information will help us to better serve you.
Complete this form to update contact information.
All fields are required
First Name
Last name
Street Address
City
State
ZIP
Phone number with area code
Station Phone number with area code
(or business phone)
(optional)
Cell Phone number with area code
Email Address
Fire Department

Your Local

Are you a PFFUI FirePAC Contributor?
Yes No
If YES, do you contribute by
Payroll Deduction?
Yes No
T-shirt size

S M L

XL 2XL

3XL 4XL

Are you retired?
Yes No
Do you have an
Indiana Firefighters License Plate?
Yes No
If YES, do you have more than one?
Include family members in same household.

Enter number of plates


Type in the names of the Plate Owners, including your own.

The following information will help us inform you about the Legislators in your area. Click here to access your information online. Scroll down to find the following on this page: Fill in your address (DO NOT abbreviate the name of your city or town) and click on the "GO" button.
My Elected Officials
Elected officials in your area

Congressional District          IN Senate, District  

IN  House of Representatives, District   

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