Member Payment OFSOA Membership Payment OFSOA Membership(Required)Payment for one member. If you have more than one member, please complete this form multiple times. Price: Member Name(Required) First Last Member Email(Required) Employment Date(Required) Month Day Year Employment Status Full Time Part Time Retired Special Status Notary Public Responder Department / Agency Name(Required) County(Required) Region(Required)Please select which OFSOA Region you are in. You can also refer to the Region map on the Resource page! Region 1 (Hood River, Wasco, Sherman, Jefferson, Wheeler, Gilliam, Morrow, Grant, Umatilla, Union, Baker, Wallowa) Region 2 (Linn, Marion, Benton, Polk, Lincoln) Region 3 (Lane, Douglas, Coos, Curry, Josephine, Jackson) Region 4 (Clatsop, Columbia, Tillamook, Washington, Yamhill, Multnomah, Clackamas) Region 5 (Deschutes, Crook, Klamath, Lake, Harney, Malheur) Chief / CEO(Required) Website Phone(Required)Department / Agency Mailing Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Department / Agency Street Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Agency Type(Required) District City Department Private Industry Other Responder Staffing Career Volunteer Combination N/A Union Staffing Union Non Union Transporting Agency Yes No Fire Med Yes No Personal Contact Information (Optional)This information will be used for cards, flowers, etc. or correspondence with Life Members and Retired Members.Home Mailing Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Home Physical Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Personal PhonePersonal Email Committee InterestAre you interested in serving on a committee or sub-committee? If so, please check the box below and the committee chair will contact you. Education Membership Protocal Communication Newsletter Website Conference Hospitality Merchandise Accreditation Goodwill Workshop Training / Subject InterestPlease list any training subjects that would help your job development and skill level:Agreement(Required) It is understood and agreed that I will abide by the Bylaws adopted by the Oregon Fire Service Office Administrators, and that I will make every effort to take an active part in the organization.Member Status(Required)Are you a new member or existing member? New Member (Never paid dues before) Existing Member (Renewing dues) Fiscal Year(Required)Which fiscal year are you paying dues for? Membership runs from July 1-June 30. Fiscal Year 2023-2024 Fiscal Year 2024-2025 Total Payment Method(Required)If you select Check/PO, please print the confirmation page as your invoice. If you select Card, you will be redirected to pay through Stripe and will receive a receipt by email. Check / PO Card NameThis field is for validation purposes and should be left unchanged. Δ
