Name:
Address:
City:
State:
Phone:
Email:
Directions from the nearest PCRFD Station which are located at Hwy 37 & Lawrence 2225 or Hwy 60 & Wallaby Rd. Simple directions are the easiest to follow. Example would be Hwy 37 north to Hwy V V then north on Hwy V V  2.5 land on left (west) side of road, Third driveway north of FR 2190.

Number of adults living in residence:
Children
Emergency Contact to contact in your absence:
Additional Livable Dwellings
New membership + Yearly Dues
$125.00
Additional Dwelling Fee
Total Amount you will be mailing.
This amount will be $125 unless you have more than one livable structure on the property. This is the amount you will mail to PCRFD.
Each additional livable dwelling on same property and not a rental are $50
Each additional livable dwelling on same property and is a rental are $75
Check if would like to receive emailed infomation
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You need to mail a check to: PCRFD, P.O. Box 134, Pierce City, Mo. 65723 within 7 days.