Fire Department Program / Speaker Request Form

Use this form to request a speaker or program about safety, careers, etc. Please complete the form and submit it at least 14 days prior to your requested program. Kindly call us with questions at 913-971-7900.

Submission of this form does not guarantee participation by us; grant permission for use of our name or logo in any advertisement; or, connect us in any manner to your event. We will contact you about the status of your request (confirm attendance; regrettably decline; suggest an alternative date; etc.). 

 

Program Type -- Please Select One
Please Select a Program
If type is "Other", please specify what type of program you would like.
Dates Requested -- All Fields are Requried
1st Choice
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2nd Choice
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3rd Choice
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Contact Information
Number of Participants By Age
CAPTCHA
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