Visiting Committee Membership Request Form

Visiting Committee Membership Request

First Name*
Last Name*
Current Visiting Committees*
- Hazardous Materials Awareness and Operations NFPA 470
Best contact phone number*
Best contact Email address*
Years of fire and/or EMS experience*
Please enter a number from 0 to 100.
Position description
- Call/Volunteer/Combination Fire Chief
- Career Fire Chief
- Career Firefighter
- Call/Volunteer Firefighter
- Public member
Organization you are representing

If you are not representing an organization please leave this blank.
Please provide a brief explanation of your experience and how it will benefit the visiting committee?*

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Concord, New Hampshire 03301

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