North Pole Fire Department

110 Lewis Street North Pole, AK 99705

Telephone: (907)488-0444 Fax: (907)488-3747

FIRE STATION VISIT REQUEST FORM

Important:

If you are planning for more than one tour date, please submit a new request form for each new date.

  1. Group Name: Enter Group Name Here

2. Today’s Date:Click here to enter a date. 3. Contact Name:Enter Contact Name.

4. Contact Phone: (Area Code) 7 Digit Phone Number 5. Contact Email: Enter Email

6. Date Requested: Click here to enter a date.

7. Time(s) you wish the tour(s) to begin:

1st Choice2nd Choice3rd Choice

Choose an item. Choose an item. Choose an item.

8. What is the age range of the intended audience?

- In the line provided please indicate the number of each age range that will be attending the visit.

Adults: Enter # Middle School/High School:Enter #

8 – 11 yrs:Enter # 6 – 7 yrs:Enter # 3 – 5 yrs:Enter #

9. Additional information for this fire prevention visit request:

Click here to add additional information

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Terms and Conditions:

Submission of this form does not guarantee your selected date by the North Pole Fire Department. Dates and times are scheduled on a first come, first serve basis, and are scheduled around Fire Department work activities. This form does not grant permission for use of the Department name or logo in any advertisement, or connect the Department in any manner to your request.

Fire Prevention Materials (goodie bags, fire hats, coloring books, brochures, ect) to be handed out are subject to availability and are seasonal in condition.

It is understood that this is a working fire station with on-duty crews; the crew may need to leave on an emergency call at any time. If this occurs, it will be necessary for the tour to end and your group to exit the station. If a tour is cancelled because the station must respond to an emergency, your tour will be rescheduled at the next mutually available time through the Fire Prevention Officer. Please call (907)488-0444 to reschedule.

Firefighters have serious work to do. Birthday party groups are welcome to tour a fire station but may not hold party festivities at the station. Please do not bring food or drink into the fire station.

I have read and understand the terms and conditions. Any falsification of this form will make it null and void:

Typing name is equal to a signature Click here to enter a date.

Signature Printed Name Date

If you wish to mail your request, send to:

North Pole Fire Department

Attn: Fire Prevention Officer

110 Lewis Street

North Pole, Alaska 99705

Or you may fax it to: (907) 488-3747 Attn: Fire Prevention Officer

For Department Use Only

Date received: ___/___/______Date tour scheduled: ___/___/_____ Time tour scheduled: ___:___

Shift on duty: _____ Fire Prevention materials needed: ___ Yes ____ No

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