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Public Education Event Request Form

2. First Name*

3. Last Name*

6. Group/School/Organization*

8. Daytime Phone #*

9. Evening Phone #*

11. Email address*

13. Type of Event*
    -- Select One --Career Day EventCommunity Event/Public EducationFire & Life Safety PresentationFire DrillFire Engine RequestFire Station TourSenior Safety Presentation

14. Length of Visit Request*
    -- Select One --10 minutes15 minutes30 minutesNot applicable

16. Date and Time of Event*
    Date and Time of Event

    Date and Time of Event

17. Alternate Date of Event*
    Alternate Date of Event

    Alternate Date of Event

20. Address of Event (if not station tour)

22. If you are looking for a station tour please select the desired station below:
    -- Select One --Station 1 - 550 Summit StStation 2 - 650 Big Timber RdStation 3 - 2455 Royal BlvdStation 4 - 599 S McLean BlvdStation 5 - 840 Villa StStation 6 - 707 W Chicago StStation 7 - 3270 Longcommon Pkwy

24. Approximate # of Adults*

25. Approximate # of Children*

26. Age Range of Intended Audience*
    -- Select One --3 - 5 years6 - 8 years9 - 11 yearsMiddle schoolChildren, various agesAdults

28. Language Needed*

29. Are there any disabilities we should be aware of?

    1. Yes
    2. No

30. Please explain

32. General subject(s) to cover

34. Any other additional information

36. The Elgin Fire Department will do everything possible to accommodate specific dates and times. However, all fire department units are in-service and must be available to respond to emergencies as needed. Due to these emergency responses, we may be delayed and in rare circumstances may be unable to attend. Firefighters also may have to cut short a visit in order to respond to an emergency. We also ask that to better accommodate your needs please submit your request as early as possible. Finally, for planning purposes, the average duration of a station tour is 30-45 minutes.

    The Elgin Fire Department will do everything possible to accommodate specific dates and times. However, all fire department units are in-service and must be available to respond to emergencies as needed. Due to these emergency responses, we may be delayed and in rare circumstances may be unable to attend. Firefighters also may have to cut short a visit in order to respond to an emergency. We also ask that to better accommodate your needs please submit your request as early as possible. Finally, for planning purposes, the average duration of a station tour is 30-45 minutes.

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38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field