Fire Safety Presentation Activity Form

Please try to schedule at least 3 weeks prior to your event.
1-60 minute presentation per day maximum.
Thank you for your cooperation.

  • Once the request has been approved, a confirmation will be sent via email or telephone.
  • Please contact our office at 204-986-5449 if you have not received confirmation within 7 days prior to your requested date.
Group Name *
Contact Person *
Number
Email Address *
Confirm Email Address *
A copy of the message will be sent to this email address.
Date of Presentation *
Time of Presentation *
to
Address *
Description of Request
Number of Participants *
Age Group *
Alternate Date of Presentation
Alternate Time of Presentation
to
Audio Visual Equipment Available * TV / DVD
Laptop with Audio
Screen
Comments / Additional information
% = the size of the detail information based on the maximum capacity for this email form. Details may not exceed 100%.

Verification Code *

 

* indicates required field.