Request A Firefighter For Fire Duty Form - Middlebury Volunteer Fire Department

Fire Duty Request Form

To Request A Middlebury Firefighter For Fire Duty

Please Use The Form Below.

Complete All Information Below And Click The Submit Button At The Bottom Of The Screen.

Incomplete Forms Can Not Be Processed.

Date Of Event:

Time Of Event:

Location Of Event (Ex. MES, MMS, Westover, etc...)

Exact Location Where Event Will Be Held (Ex. Gym, Hallway, Cafateria, etc...)

Type Of Event (Ex. Dance, Concert, etc...)

Number Of People Who Will Be Attending.

Please Note: If more than 200 people will be attending you will need 2 firefighters

Number Of Firefighters You Are Requesting

Group Or Grade Sponsoring This Event (Ex. 6th Grade Dance, PTO, ect...)

Purchase Order Number

Billing Contact Person

Daytime Phone

Email Address: Confirmation Will Be Sent To This Address.

Billing Address:

Special Instructions Or Comments:

The minimum fee for services rendered is $150.80 per firefighter.

Please make checks payable to: Middlebury Volunteer Fire Department

Mail Remittance To:

Middlebury Volunteer Fire Department

P.O. Box 126

Middlebury, CT 06762

Any Questions Please

E-Mail Us

Home

Location Of Event (Ex. MES, MMS, Westover, etc...)
Exact Location Where Event Will Be Held (Ex. Gym, Hallway, Cafateria, etc...)
Type Of Event (Ex. Dance, Concert, etc...)
Number Of People Who Will Be Attending.	Please Note: If more than 200 people will be attending you will need 2 firefighters
Number Of Firefighters You Are Requesting
Group Or Grade Sponsoring This Event (Ex. 6th Grade Dance, PTO, ect...)
Purchase Order Number
Billing Contact Person
Daytime Phone
Email Address: Confirmation Will Be Sent To This Address.
Billing Address: Special Instructions Or Comments:
The minimum fee for services rendered is $150.80 per firefighter. Please make checks payable to: Middlebury Volunteer Fire Department *Mail Remittance To:* Middlebury Volunteer Fire Department P.O. Box 126 Middlebury, CT 06762 Any Questions Please E-Mail Us