REQUEST FOR FIRE SAFETY HOUSE

This request form is needed at least three (3) weeks prior to the projected date of
tour. All requests must either be submitted by the following form, or mailed to:
Presque Isle Fire Department
43 North Street, Suite A
Presque Isle, ME 04769

Note: Requests for the Fire Safety House cannot be taken by telephone.

Organization Name:
Address:
Contact Person:
Telephone Number:
Date and Time Requested:
Date and Time of Return:
Location of Use:
Type of Program:
Level Entrance and Exit: Yes No
Level Parking Area: Yes No
Location Free of Hazzards: Yes No
Provide a 30AMP Outlet: Yes No
Expected Children Per Day:
Expected Age Group:
Additional Comments:
The Fire Safety House is a 35 Ft. Long Trailer Home. Only qualified/designated members of PIFD will be allowed to tow
and operate the safety house. The receiving entities (outside of Presque Isle) will be responsible for fuel costs to
deliver the trailer and will provide their own educational materials (pamphlets, brochures etc.)
In the event of inclement weather, the Fire Department/Education Section reserves the right to reschedule the Fire
Safety House Tour.
Note: We (Presque Isle Fire Dept.) reserve the right to deny display of the
Fire Safety House based on the information provided.