Outreach Program Request

Prior to completing the below form, please consider the following guidelines. We look forward to being a part of your event! 

1. Notice must be made to the fire and rescue department no less than 7 days prior to the schedule event, 10 is preferred. If it is less than 7 days before your event, we cannot guarantee that a crew will be there.
2. Crews are available for 2 hours, but may have to run emergency calls during the event. If you need additional time, please indicate when filling out the form.
3. Apparatus will need to be positioned in such a way that they can quickly exit in the event of an emergency.
4. It is important that you provide the estimated number of participants, this is critical to our planning.

Edit Form

Community Outreach Request Form

Community engagement and public education is important to the Stafford County Fire and Rescue Department. Please complete this form at least 10 days prior to your requested program.

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First Name*

Last Name*

Phone Number*

Email*

Date of requested program*?

Time of Program*

Location of requested program*

Number of participants expected*

Age Group of Participants*

If this is for a community event, will you be charging admission?

Yes

No

Type of Program

CPR Certification

Home Safety Survey

Fire and Life Safety program

Fire Station Visit

Emergency Preparedness Program

Smoke Alarm Installation

Other

Topics for Program

Fire Safety

Fire Escape Plans

Cooking Safety

Emergency Preparedness

Lighters and Matches

Holiday Safety

Emergency medical information

Other

Preferred Method of Contact*?

Email

Phone

Are there any special needs we should be aware of?*?

Additional comments*?