2. 

   Citizens Fire Academy Registration Form

4. First Name:*
5. Last Name:*
7. Home Address:*
8. Email:*
10. Phone Number:*
11. Shirt Size:*
13. Photography or Video

    Photos and/or video will be taken during the Citizens Fire Academy. Photos or videos may be displayed in the Municipal Center, posted on our website or social media platforms, placed in Township publications, submitted to media, or other. Please contact the Communications Department to opt out of photographic opportunities.

Leave This Blank:


17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

* indicates a required field