Form Center

2. Fire Department Name
4. County
5. FDID #
7. Physical Address
9. City
10. State
11. Zip Code
13. Mailing Address
15. City
16. State
17. Zip Code
19. Station Phone Number
20. Fax Number
22. Station Classification
    -- Select One --VolunteerCareerCombination
24. Number of Stations
25. Number of Members
26. Number of Volunteer Firefighters
27. Number of Career Firefighters
29. Current Method of NFIRS Reporting

    1. eNFIRS
    2. Other
30. If Other, Software Vendor Name
32. Senior Staff Contact Information
34. Postion
35. Name
36. Phone Number
37. Email
39. Position
40. Name
41. Phone Number
42. Email
44. Position
45. Name
46. Phone Number
47. Email
49. Position
50. Name
51. Phone Number
52. Email
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field