2. Name*
4. Organization
6. Phone Number:*
8. 
   
10. Date:*
12. Start Time:*
14. End Time:*
16. Who is the target audience?*
18. Address of event*
20. What type of event is it?*
21. Do you have booths set up at the event?*
    -- Select One --YesNo
23. Any specific message that you want the FD to focus on?*
25. Do you want the Fire Truck, Ambuance or Both?

    1. None
    2. Fire Truck
    3. Ambulance
    4. Both
27. L.A.F.S Clowns (Available for schools and community events only)

    1. Yes
29. School or Community Event Name requesting L.A.F.S program:
31. Do you want us to show the equipment?

    1. Yes
    2. No
33. Requests:

    1. Stickers
    2. Coloring Books
    3. Pencils
35. How long do you expect the FD to be at the event?*
37. Comments.
39. Request subject to approval. You will be contacted once approved.
Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit Submit and Print

* indicates a required field