Application for Membership

IFHV Application for Membership

Dues renew on a calendar year.

Business Name*

Establishment Number*

Owner's Name*

FD License Number*

Primary Contact (if other than owner)

Phone Number*

Fax

Email*

Number of Locations*

Number of Services per year (all locations)*

Location #1 Business Name*

#1 Name of Manager*

#1 FD License Number*

#1 Address*

#1 Phone Number*

#1 Email*

Would you be willing to serve on the committees below? (Check all that apply):

Board Member and/ or officer
Membership
Continuing Education
Legislative/government
Purchasing Cooperative
Cremation Certification

Dues Schedule

Total Number of Services Per Year Including All Locations*

0-50 Services Per Year ($270.00)
51-150 Services Per Year ($425.00)
151-300 Services Per Year ($725.00)
301-500 Services Per Year ($1,050.00)
500+ Services Per Year ($1,350.00)
Associate Member (Suppliers) ($450.00)

IRS Required Notice: Dues, contributions, or gifts to IFHV are not tax deductible as charitable contributions for income purposes but may be tax deductible as ordinary and necessary business expenses subject to restrictions (federal definition of "lobbying") imposed as a result of IFHV lobbying activities. IFHV estimates the non-deductible portion of this year's dues, the portion of which is allocable to lobbying, is 40%

Total

$0.00

Coupon Code

Billing Information

Name*

Credit Card*

Visa
Mastercard
American Express
Discover

Address*

Email*

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