The Association of Fire Districts of the State of New York - The Association of Fire Districts of the State of New York

This form is being submitted for a deceased Fire District officer to be recognized at the October 2026 Annual Memorial Service

First Name *

Last Name *

Email *

Address *

Address 2

City *

State *

Zip *

FIRST NAME of Honoree (Please submit as you wish it to appear in the program) *

LAST NAME of Honoree (Please submit as you wish it to appear in the program) *

Name of the Honoree's FIRE DISTRICT *

TITLE (S) held by the Honoree
Choose up to 5

Commissioner

Secretary

Treasurer

Deputy Treasurer

Chief

Other

If OTHER please list:

In what COUNTY (with in NYS) was the Honoree's Fire District located?

2026 Memorial Honorees