LHFD Fire Prevention Visit Request

Thank you for your interest in a

Long Hill Fire Department Fire Prevention Visit

Please note: Submission of this form does NOT confirm your appointment.
All requests are subject to volunteer availability. Our team will review your request and contact you to confirm or coordinate an alternate date. Please contact Sandra Trotta at strotta@longhillfd.com or (203) 261-3912 with questions.

Organization/School Name*

Contact Name*

First NameLast Name

Contact Phone*

Please enter a valid phone number.Format: (000) 000-0000.

Contact Email*

example@example.com

Type of Visit*

If visiting a fire station, please choose the location below:

If you would like the fire department to come to your location, please provide the details below:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

First Choice Date and Start Time

Date

Hour MinutesAM/PM Option

Second Choice Date and Start Time

Date

Hour MinutesAM/PM Option

Program Details by Age Group

Under Age 2: We are unable to accommodate visits for this age group.

Ages 2–3: A brief visit (approximately 10 minutes) to meet firefighters and see a fire engine.

Ages 4–10: A short, age-appropriate fire prevention lesson and activity. If time and weather permit, participants may also view fire apparatus outside.

Younger children will receive coloring books to take home, encouraging continued fire safety discussions with their families.

Ages 10 & Up: In the note section at the bottom of this form, please indicate if there are any specific topics you would like covered for this age group.

Audience Information*

Estimated number of participants*

Special Requests / Notes: Please use this space to provide any additional details to help us plan your visit. This may include whether we will be teaching multiple classes (and the number of participants in each), as well as any specific arrival instructions such as meeting locations or parking information. Audio/visual equipment is not required for our presentation; however, if you prefer this format, please indicate that here.