Gurnee Fire Department
Public Event Request Form

Please complete the form below to request a Public Education Event.
All fields marked with an asterisk (*) are REQUIRED.

**Name:

Street Address:

City:

    State:     Zip:

Primary Phone:

- - Secondary Phone: - -

eMail Address:

Date of Event:
(Fire will notify you regarding date availability)
1st Choice: / /          Time of Event:
2nd Choice: / /         Time of Event:

Event Location:
(Please supply address
if different than above):

City:     State:     Zip:

Estimated Number
of People:
Age of Audience:

Topic:
Home Inspections
Fire Station Tours

Additional Comments:

Do not consider any events to be definite until contacted by the Fire Department.

Thank you for your interest in the Gurnee Fire Department!***

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The Village of Gurnee Fire Department / Public Education Request Form / Last Revised 01/11/2006

Gurnee Fire Department Public Event Request Form