Greensboro Fire Request Form

Full Name*

First NameLast Name

Contact Phone*

Alternate Phone

E-mail Address*

example@example.com

Organization/Business Name

For reference: Detailed list of education programs & services

OLD Select the educational program, event, class or service you are interested in.*

Select the educational program, event, class or service you are interested in.*

Select the type of Community Event*

Select the type of Class*

Daycare Training ClassMy Friend the Firefighter (Pre-K - 2nd grade)5th Grade Education ClassFire Extinguisher classGeneral Home Fire Safety Class (Age 18+)Seniors Fire and Fall Prevention Class (Age 55+)Assisted Living Staff Training (Ages 18+)Code Compliance ClassIndustrial Fire Safety

Select the type of Combo Class*

General Home Safety Class and Fire Extinguisher TrainingDay Care Training Class and Fire Extinguisher TrainingSeniors Fire and Fall Prevention Class and Fire Extinguisher TrainingAssisted Living Staff Training and Fire Extinguisher TrainingCode Compliance Class and Fire Extinguisher TrainingHealth Fair/Festival Information Tent and Fire Engine Display

Select the type of Service*

Elderlinks (Age 55+)Fire DrillSafe at Home CheckSignal 3

Select the type of Program*

Career FairRide Along

Station Tours not available at this time

due to COVID

We are no longer accepting requests for Fire Prevention Week activities.

Click here to be redirected to the 5th Grade Fire Education Sign-Up (office365.com)

Click here to be redirected to the GFD Ride-Along Registration form.

Address that Event/Class will take place*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Year of home build *

Provide the year the home was built

How many people estimated to attend event?*

We request that Fire Safety Trailer Events be scheduled for groups of 50 or more.

Age Group*

Day of Week Preferred*

Date of Event: First Choice*

NOTE: We require a 21 day notice prior to your event

Do you have a second choice for your event?

YesNo

Date of Event: Second Choice*

Note: We require a 21 day notice prior to your event

Fire Prevention Week: First Choice (select Oct 6-12 only)*

NOTE: We require a 21 day notice prior to your event

Fire Prevention Week: Second Choice (select Oct 6-12 only)*

Note: We require a 21 day notice prior to your event

Service Date: First Choice*

Service Date: Second Choice*

Event Start and End Time *NOTE: events will not be scheduled longer than the 2 hour maximum*

:HourMinutes

and will END at

until :HourMinutes

Event Start and End Time *NOTE: events will not be scheduled longer than the 1 hour maximum*

:HourMinutes

and will END at

until :HourMinutes

Events should not be scheduled longer than 2 hours. Please correct the Event Start and/or End Time

Events should not be scheduled longer than 1 hour. Please correct the Event Start and/or End Time

Hidden Duration for 2 hours

Hidden Duration for 1 hour

Comments (limited to 750 characters)