Form Builder - City of Burlington

Required fields are marked with asterisks (*)

Request for Fire Department Presentation

Purpose
This form is to request a member of the Burlington Fire Department’s prevention and education team deliver fire and life safety education to your organization.

To request a fire truck and firefighter attendance at an event, please complete the Fire Truck Visit Request Form.

Notice of Collection

Personal information contained on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, c. 25, and will be used for the purposes of administering your request for the Burlington Fire Department to attend or present. Questions about this collection can be directed to Public Education Officer, Burlington Fire Department, 1255 Fairview Street, Burlington, ON L7S 1Y3 or by email firedepartment@burlington.ca

Please read carefully before booking your presentation request:

Presentation requests must be booked a minimum of 2 weeks before the event date. While we do our best to accommodate all requests, we do book up quickly so 4-6 weeks’ notice is advised.
The majority of the intended audience/event participants must be 5 years of age or older to ensure optimal comprehension of the fire prevention and life safety content presented.
You will receive an email from firedepartment@burlington.ca with a confirmation of booking your presentation.

Requestor Information

Organization

First Name

Last Name

E-mail address

Telephone Number

Name of contact person on day of event (if different than above):

Email address

Phone number:

Event and Presentation Details

Name of Event

Date of Event:

Event Location

Start time:

End time:

Type of Fire and Life Safety Education:

In-person presentation

Virtual education presentation

Information table only

Please provide additional details including a brief description of the event, specific instructions or requests for fire department presenter. Topics for presenter to cover: [Please list up to 3, based on learning objectives]

Will audio/visual equipment be available for the presenter?

Yes

Will there be other presenters at the event?

Yes

Have or will you also be requesting a fire truck visit for the same date?

Yes

Audience Details

Estimated number of attendees:

Please provide and note any special needs of audience members and/or instructions:

Does your organization have a social media account(s)? If so, list account handles for each platform below.

Please follow us on @BurlingtonFireDept on Facebook and @BurlingtonFire on X.