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Muscatine Fire Department Safety Education Program Request
Leave This Blank:
Please provide as much information as possible about your event. MFD asks that requests be submitted at least 10 calendar days in advance.
Today's Date
*
Event Date
*
Time(s) Requested
*
Contact Person
*
Contact Phone and Email
*
Program Request
*
Fire Engine Visit
Ambulance Visit
Station Tour only
Station Tour with Freddie presentation
School Visit - Public Education Grades K-4
Presenter only - Example: Science class looking for a paramedic to talk about EKG.
Expected # in Attendance
*
Event Location - Address
*
Is this for an educational organization or community/non-profit group?
*
Yes
No
Name of organization or group
*
PLEASE NOTE: Fire department personnel and apparatuses
do not make appearances at private parties or for profit functions.
(e.g. grand opening event for a new business,
birthday parties, etc.)
* indicates required fields.
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