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Batesville Fire Department
Public Education Online Request Form

The intent of this form is to allow you to request a fire education program through this fire department web site. Please fill out the following form and provide as much information as possible. Upon completion of the form, click the SUBMIT button at the bottom of the page.   Once the email is received, you will receive an email or phone call.  Generally, it is preferred to have a one week notice so that we may schedule in advance.  You may also call 662-563-6690 or 662-563-6610 and make your request by telephone, but please provide all the information listed below.

If the tour is at a station, sometimes the engines are called out on an emergency and have to leave the station. It is recommended that you wait a few minutes to see if the engines return. If they do not, please call and reschedule for a later date.

Requested By:                     

Group Name:                       

Email Address:                    

Date and Time:                    

Location / Address:             

Contact Phone #:                 

Type of Program Desired:    

Pick Station:                         

Number of Children:           

Number of Adults:               

Age Group:                          

Comments:                           

Please contact me as soon as possible regarding this matter.


Author Chris Olson
Copyright © 2001 [Batesville Fire Department]. All rights reserved.
Revised: 07/19/04.