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Membership Status Change Request
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First Name
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Last Name
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Membership Status Change
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Resignation
Transfer Request
Leave of Absence
Current Department
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Blue Ridge
Troutville
Buchanan
Fincastle
Eagle Rock
Glen Wilton
Read Mountain
If transferring, which station is the member requesting to transfer to?
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Blue Ridge
Troutville
Buchanan
Fincastle
Eagle Rock
Glen Wilton
Read Mountain
If transferring, please submit a recommendation letter to transfer.
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