Fire Safety Presentation Activity Form

Please try to schedule at least 3 weeks prior to your event.
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
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