Public Education / Event Request Form

Public Education / Event Request Form
If you would like to request St Matthews Fire & EMS for a Public Education Program or to participate in your event, please fill out the request form below.
NOTICE:
This request form is not a confirmation of the program requested. After submitting, you will receive a response from a member of the Fire Prevention Bureau with an approval or denial of your request or to obtain more details regarding the program.
Program Event Date*

MonthDayYear
Date
Start Time (Approx.)*

:HourMinutesAM/PM Option
End Time*

:HourMinutesAM/PM Option
Organization / Sponsor*
Organization/Sponsor Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Event Location*
Event Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Event / Program Category*
If Birthday Party Please Download This Form As Well. Download Here
If Station Tour or Station Use, Select Which Station
Event Description*
Attendance:
Please provide the estimated attendance of the program/event below.
# Adults Attending
# Children Attending
Contact Info
Please enter your contact information below.
Contact Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Mailing Address

St Matthews Fire & Rescue

240 Sears Ave.

Louisville, Ky 40207
Should be Empty: