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Department Name *
Department Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Your Name First Last
Your Email *
Number of Current Live-Ins *

Please enter the number of personnel that currently live in your station.
Area Colleges and Universities *

Please list the colleges and universities that surround your department. These schools should be within reasonable daily commuting distance from your department.
Certification Requirements *

Please insert requirements for live-ins such as fire and EMS certifications required to live at the firehouse.
Station Amenities
Private Rooms Semi-Private Rooms Washer and Dryer Refrigerator Freezer Full Kitchen Personal Food Storage Computers Wireless Internet Access Exercise Area Study Area

Please check where applicable.
Apparatus
Engine Truck Rescue ALS Ambulance BLS Ambulance Brush Truck Haz Mat Unit Snorkel Tanker Utility Vehicle Air Cascade EMS Vehicle
Do Not Fill This Out

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