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2. Every child participates in fire drills at school, but we go beyond that. Our Safety House Program brings hands-on fire safety education directly to schools, daycare centers, and community events. Request a visit from the Safety House by completing the Smoke House Demo Form below. 

4. Request Date
   Request Date
6. Requesters Name
8. Location Name
9. Location Address
11. Location Type

    1. School
    2. Daycare
    3. Community Event
    4. Other
13. If other please specify
15. Preferred Demonstration Date
    Preferred Demonstration Date
17. Preferred Time

    1. 9 A.M. – 11 A.M.
    2. 1 P.M. – 3 P.M.
    3. 6 P.M. – 8 P.M.
Leave This Blank:


19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit

* indicates a required field