Washington State Region 5
Fire Investigation & Life Safety Council

Smoke Alarm Request Form

WA State Region 5 Fire Investigation & Life Safety Council offers free 10-year lithium smoke alarms to fire agencies within Region 5’s area. If you would like to receive free smoke alarms, please fill out the form below. There is a maximum of 40 smoke alarms that can be requested at one time. Please Note: ALL fields are required to be filled in (except additional comments) in order to receive your smoke alarms requested!

 

  Contact Information
Agency
Contact Name
Physical Address
Mailing Address
City
State
Zip
Contact Phone Number
Contact Email
Quantity Requested
Description of Program
(What program do you
have in place to distribute
smoke alarms for
your community)
Additional Comments

Within approximately seven (7) days after your request, you will receive a confirmation of your request and directions for pick-up location/arrangements will be made.

Return Completed Forms By Mail, Email or Fax To:
WA State Region 5 Fire Investigation & Life Safety Council
C/O Brandi Ballinger
701 Vine Street
Kelso WA 98626
360-575-6280 (phone)
360-578-5220 (fax)
brandi.ballinger@c2fr.org

You may return to our Home Page, by clicking here.

 

[ Home ] [ Contact Us ] [ Site Index ]

Copyright © 2008 Washington State Region 5 Fire Investigation & Life Safety Council