Fire and Life Safety Prevention Request

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               Town of Chapel Hill Logo                              Fire Department Patch               

     TOWN OF CHAPEL HILL
     Fire Department

     403 Martin Luther King Jr. Blvd.
     Chapel Hill, NC 27514-5705

     phone (919) 968-2781 fax (919) 932-2956
     www.townofchapelhill.org

Please correct the field(s) marked in red below:

1
Contact Information
 *
Contact Information
2
Date and Time
 *
Date and Time
3
Anticipated Attendance (quantity)
Anticipated Attendance (quantity)
4
Type of Request
 *
Type of Request
5
Additional Information (optional)
Requests are subject to availability, please make your requests 14 days in advance. All efforts are made to fulfill as requested; however, at the discretion of the Educator a program may change. Emergency Response is the Department’s first priority.
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