DFD Special Event

CONTACT NAME*

First Name

Last Name

ORGANIZATION NAME

PHONE NUMBER

EMAIL ADDRESS

WHAT IS THIS EVENT FOR?*

FIRE PREVENTION: SCHOOLS AND DAYCARES ONLY COMMUNITY/SPECIAL EVENT

SELECT ONLY ONE. CHOOSE THE ONE THAT BEST FITS YOUR EVENT

ARE YOU REQUESTING A STATION VISIT OR AN ENGINE VISIT TO YOUR SITE?

STATION VISIT REQUEST AN ENGINE TO YOUR SITE

ADDRESS OF LOCATION

Address Line 1

Address Line 2

City

State

ZIP Code

DATE AND TIME OF EVENT (1ST CHOICE)

:

DATE AND TIME OF EVENT (2ND CHOICE)

:

NUMBER OF PARTICIPANTS

AGE RANGE OF PARTICIPANTS

NAME OF EVENT

ADDRESS OF LOCATION

Address Line 1

Address Line 2

City

DATE AND TIME OF EVENT

:

AGE RANGE OF PARTICIPANTS

NUMBER OF PARTICIPANTS

DO YOU HAVE A SPECIAL EVENT PERMIT WITH THE CITY OF DOVER?

YES, I HAVE AN APPOVED PERMIT I HAVE SUBMITTED AN APPLICATION AND I AM WAITING FOR APPROVAL I HAVE NOT APPLIED FOR A SPECIAL EVENT PERMIT YET MY EVENT DOES NOT REQUIRE A SPECIAL EVENT PERMIT (THIS HAS TO BE CONFIRMBED BY THE CITY OF DOVER)

ONLY SELECT ONE OPTION. FOR QUESTIONS ON THE CITY OF DOVER SPECIAL EVENT, PLEASE CALL THE CITY AT 302-736-7011

WOULD YOU BE WILLING TO MAKE A DONATION OF $50.00 TO THE DOVER FIRE DEPARTMENT 2 WEEKS PRIOR TO YOUR EVENT?

YES NO

A REPRESENTATIVE FROM THE DOVER FIRE DEPARTMENT WILL BE IN CONTACT WITH YOU ONCE YOUR REQUEST HAS BEEN RECIEVED TO CONFIRM THE INFORMATION AND SCHEDULE THE EVENT IF AVAILABLE.

ALL SCHEDULED APPEARANCES ARE SUBJECT TO CHANGE IN THE EVENT OF AN EMERGENCY.