The Cloverdale Volunteer Firefighters Association provides address signs to District Residents at a cost of $15^.00

for each sign. The fee includes installation within approximately 4 weeks.

             68787 George Cyrus Rd. Sisters, OR 97759

Name:___________________________________________________

Address:_________________________________________________

City:____________________________________________________

Phone # Daytime:____________________ Evening:__________________

Physical Address if different from above:

_________________________________________________________

Total Enclosed:    # _______ signs $15^{.00 each = ______________}

Print and fill out the following form and remit to: Cloverdale Volunteer Firefighters Association

             68787 George Cyrus Rd. Sisters, OR 97759