Fire Education Program
MODEL T Vehicle Appearance Request Form

Requesting Organization:___________________________________________________

Contact Name:__________________________________________________________

Contact Phone:________________________ E-mail:____________________________

Mailing Address:________________________________________________________

Event or Activity:________________________________________________________

Date:___________________________ Duration of Event:________________________

Time for Arrival__________________________ Departure_______________________

Model T will be utilized for: ___(A) Display ___(B) Parade/drive around ___(C) Both

Do you need assistance arranging for ____Fire Engine ____Smokey Bear?

If for USFS activity, are you arranging transportation? _____ YES _____NO

Contact name for transportation, if different from Contact above______________________

++++++++++++FOR INTERNAL FIRE ED PROGRAM USE ONLY+++++++++++++

Date Confirmed on Calendar___________ Costs, if applicable______________________

Trailer Driver confirmed - Name:_____________________________________________

Model T Driver Confirmed - Name:___________________________________________

Volunteer Staff confirmed - Names:___________________________________________
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Post Event Comments:_____________________________________________________
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