2. The Clay Fire Territory values the opportunity to provide presentations and tours and want to thank you for letting us be of service to you and your group.

   
   

   We ask that you take a few minutes to evaluate your experience with our department so that we may provide the best in age and time appropriate programs.

   
   

   After completing this form, please use the self-addressed stamped envelope to return it to us. Thanks for your assistance.

   
   

   Ron Melser Jr.

   Fire Marshal

4. Name and location of event*
6. Date of Program/Presentation*
   Date of Program/Presentation

   Date of Program/Presentation
8. Address1
10. City
11. State
12. Zip
14. Contact Name
15. Last Name
17. Phone Number
18. Type of Program
20. Number in Attendance
21. What were the approximate ages of those attending this program?
23. How was the length of the program?*

    1. Appropriate
    2. Too long
    3. Too short
25. Did you feel confident and comfortable with the presenter(s)? *

    1. Yes
    2. No
27. If you chose "No," please explain.
29. Was the program/presentation a positive experience? *

    1. Yes
    2. No
31. If you chose "No," please explain.
33. Would you contact our department again in the future for programs/presentations?*

    1. Yes
    2. No
35. Comments about your experience
    Please provide us with feedback so that we may continue to improve our programs to better serve the needs of our community.
37. What other presentation would you like to see?
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field