Exit Survey  »
Questions marked with a * are required
100%
PLEASE SUBMIT YOUR RESPONSES BY FRIDAY, FEBRUARY 1, 2013. If you have questions, please call Jeff Barrington at 1-800-547-7377 ext. 6229.
 
 
Department name: *
 
Town/City/County *
 
 
 
 
State/Province *
 
 
 
Community character: *
 
 
 
Response area in square miles: *
 
Population protected: *
 
Annual operating budget: *
 
Total fire calls in 2012 (non-EMS responses): *
 
Total EMS calls in 2012 (if not applicable, please enter NA): *
 
Number of stations: *
 
Total pieces of emergency response apparatus (excluding staff cars): *
 
Number of full-time career members: *
 
Number of volunteer members: *
 
Number of paid-on-call members (if not applicable, please enter NA): *
 
Number of part-time career members (if not applicable, please enter NA): *
 
How many full-time equivalents (FTEs) does your department use (if not applicable, please enter NA)? *
 
ISO Rating: *
 
 
 
 
Name of person completing form: *
 
 
 
 
Rank of person completing form: *
 
 
 
Contact Information
Address 1:  
Address 2:  
City:
      State/Province:         Zip:    
 
 
 
Email Address
 
 
 
Contact Information
Phone Number: