Fsf Regional Equipment Donation Request Form

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Firefighters Support Foundation (FSF)
The Foundation for First Responders and Firefighters Special Project
Regional Equipment Donation Request Form
RETURN THE COMPLETED FORM TO: FSF, 40 School Street, Suite 8, Greenfield, MA 01301
Please mail a hard copy, single sided only, rather than an electronic version.
What will happen after you mail this application in:
-- You can assume we received it
-- We will email or call you if you are selected
-- Please note that we receive many more grant applications than we can fund
Section I Requesting Agency
1. Agency Name:
2. Agency Mailing Address:
Section II Contact Information
1. Name:
2. E-mail address:
(We normally communicate by email and require a working and regularly checked email address)
3. Phone with area code:
Section III Agency Profile
1. Number of total firefighters or EMTs in agency:
2. Number of full-time firefighters or EMTs:
3. Number of additional first responders that will be able to use this equipment:
Law enforcement:
Emergency management:
Other (specify):
4. Geographic region that equipment will be made available in:


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