CFD Community Program Request

Requester Information

Full Name

First Name *

Last Name *

Contact Phone Number

Contact Email

Name of Organization / School

Type of Program Being Requested

FIRE TRUCK VISIT [Description: Community events, schools, best for all ages]

BLAZE, Charlotte Fire Department Mascot [Description: Community events, for ages 6+, no childcare/daycare locations]

GENERAL FIRE SAFETY PRESENTATION [Description: No Fire Truck - best for adults and seniors]

FIRE EXTINGUISHER TRAINING [Description: No Fire Truck - adults (16+), minimum of 20 participants, no live fire]

CURRICULUM-BASED CLASSROOM PRESENTATION [Description: No Fire Truck - 3rd grade, 7th grade and High School fire safety]

Event Date

Requested Event Times

START Time [HH:MM AM/PM] *

END Time [HH:MM AM/PM] *

Expected Number of Participants - Ages 0-17

Expected Number of Participants - Ages 18+

Additional Information