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2. Please note that pursuant to the state’s Public Records Act (RCW 42.56), documents are public records and may be subject to public disclosure. 

4. 
6. Public Education / Community Outreach Request
   Fire prevention and safety is a team effort between you and the Fire Marshal's Office. We offer educational programs to teach fire safety and prevention to children, seniors and local businesses in our community.
   
   We want to partner with you to present information that is relevant to your group's needs. Please complete and submit this form. We look forward to working with you!
8. Contact Name*
9. Name of your group or organization*
11. Email Address*
12. Phone Number*
16. Would you like to schedule a station tour?*

    1. Yes
    2. No
17. Station Tour

    Please select a station from the list below. To learn more about station locations, visit www.fire3.org/about-us/stations

    1. Station 31 - Hockinson, Finn Hill, Brush Prairie
    2. Station 32 - Venersborg, Bells Mountain
    3. Station 33 - Battle Ground Lake, Heisson, Lucia Falls
    4. Station 34 - Rawson Rd., Elkhorn Mountain, Summer Hills
    5. Station 35 - City of Battle Ground Station
21. Would you like us visit your location with fire apparatus?*

    Fire District 3 delivers service with a variety of apparatus types (fire engines, water tenders, squads, and rescue vehicles). Learn about apparatus types at www.fire3.org/about-us/apparatus-1

    1. Yes
    2. No
22. Type of appartus
    -- Select One --Fire EngineWater TenderRescue VehicleSquad

    Let us know what apparatus you would like us to bring to you location
24. Type of location for apparatus visit*

    Please select the location type below.

    1. Preschool
    2. Primary School
    3. Middle School

    1. High School
    2. Business
    3. Special Event
25. Address of location for apparatus visit*
27. Please describe your Special Event*
31. Would you like us be a guest speaker at your meeting or event?*

    There are several topics we can present to your group or organization

    1. Yes
    2. No
32. Guest speaker request

    What topic/s would you like us to present?

    1. Programs Overview
    2. Community Health
    3. Juvenile Firesetting
    4. Escape Planning

    1. Fire Extinguisher Use
    2. Senior Home Safety
    3. Recruitment
    4. Other
34. Other topic
    Please describe the topic for which you would like us to speak.
38. Tell us more about your group or organization
40. What is the age or ages of the outreach audience?*

    Please check all that apply.

    1. Pre-K - 2nd Grade
    2. 3rd - 5th Grade
    3. 6th - 8th Grade

    1. 9th - 12th Grade
    2. Adult
    3. Senior
41. Estimated number of children*
42. Estimated Number of Adults*
44. Preferred Date*
    Preferred Date
45. Preferred Start Time*
    Preferred Start Time
46. Preferred End Time*
    Preferred End Time
48. Alternate Date*
    Alternate Date
49. Alternate Date - Start Time*
    Alternate Date - Start Time
50. Alternate Date - End Time*
    Alternate Date - End Time
52. Please provide any other information you would like us to know
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit Submit and Print

* indicates a required field