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2. NOTICE

   Request for Special Events must be made a minimum of 72 hours before start of Event. Requests made less than 72 hours notice is subject to availability and must be requested by emailing Roman Scott, Public Education Officer, at rscott@cityofshelbyvillein.com.

4. Name*

   Person of Contact

5. Email Address*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Group/Organization Making Request

    If different than name of requester

16. Date/Time Requested*
    Date/Time Requested

    Date/Time Requested
17. Type of Request*
    -- Select One --Station TourFire Truck for Special Event
19. Name of Event

    If request is for truck on site

20. What is the Event For?*
22. Address of Event
24. City
25. State
26. Zip Code
28. Number of Adult Participants*
29. Number of Youth Participants?*
31. Event Details*
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field