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2. Complete this form to request a fire station tour, participate in a community event, or arrange a public education (Pub-Ed) or community outreach (CO) appearance.  Requests must be submitted at least two weeks prior to the even. Confirmation will be sent within five (5) business days.  Events not approved for participation:

   • Birthday parties (station tours are acceptable)
   • Events without public interaction or educational value
   • Store sales or promotional events
   • Commercial events lacking a community education purpose
6. Section 1: Requester Information
8. Name of Organization or Individual
10. Contact First Name*
11. Contact Last Name*
13. Phone Number*
14. Email Address*
18. Section 2: Event Details
20. Event Name / Description*
22. Event Type*

    Check all that apply

    1. Fire Station Tour
    2. Block Party / Carnival / Special Event
    3. School Event / Fire Prevention Week
    4. Daycare Visit

    1. Trade Show / Safety Fair
    2. Fire Extinguisher Training
    3. Community / Training Room Use
    4. Other
23. Other

    If other was selected, please state a type in the box above.

25. Date of Event*
    Date of Event
26. Start Time*
    Start Time
27. End Time*
    End Time
29. Address 1*

    Location/Address of Event

31. Address 2
33. City*
34. State*
35. Zip*
37. Expected Number of Participants
38. Target Age Group
40. Special Requests

    Demonstrations, Apparatus Display, Fire Safety Talk, etc.

42. Requester Signature*

    Type your name here.

43. Date*
    Date
45. My signature is evidence that I have read and agree with the above statements.
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field