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Program Request Form

Contact Person's Name: *



Phone Number of Contact Person: *

E-mail of Contact Person: *

Date of Event: * Please use xx/xx/xxxx format
We require at least 3 weeks advance notice. Please do not submit a request if your event is less than 3 weeks away.

Time of Event (Please state starting and ending time):


Type of Program:  *

Location of Program: *  ex. Room # / Parking Lot / Intersection / etc.

Expected Attendance:

Age Group of Participants:

Additional Information (please give us a short description of the event and the resources you would like MIlwaukee Fire Department to provide).

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