Form Center

2. Public Education Request Form
   Hampton Fire & Rescue personnel are happy to assist you by scheduling a fire safety education program at your Hampton location or having your group take a tour of any of our stations. We do not, however, attend birthday parties or allow them to be held at our fire stations. Our calendars fill quickly so please have flexible dates and SUBMIT YOUR REQUESTS AT LEAST 30 DAYS IN ADVANCE. Please note that we must be available to respond to emergencies, which means that our stay may be shorter than what was requested.
4. Organization Name
6. Contact Person*
7. Email address*
9. Full Address of Event*
11. Building/Suite #
12. Zip*
14. Best Contact Phone #*
15. Best Time to Call*
    Best Time to Call Start Time

    —

    Best Time to Call End Time
17. Interest (Select at least one)*

    1. Fire Extinguisher Training
    2. Senior Safety Program
    3. Workplace Safety
    4. Home Safety Survey
    5. Life Safety House Demonstration

    1. Fire Truck Demonstration
    2. Medic Demonstration
    3. Fire Station Tour (Please specify which station below)
    4. Other (Please specify below)
19. Additional Information:
    If you selected "Fire Station Tour" or "Other", please enter the fire station within your district below or other interests that are not listed above.
21. Desired Date & Time*
    Desired Date & Time

    Desired Date & Time
23. Number of Participants*
24. Age Group of Participants*
26. Provide Us With Additional Helpful Details Regarding Your Request*
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field