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2. First Name*
3. Last Name*
5. Address*
7. City*
9. Phone Number*
10. Email Address
12. Are you 18 years of age or older?*

    1. Yes
    2. No

    CFA students must be 18+ years old to participate.
13. Do you have any special needs that would require accommodations in order for you to participate in this program?

    1. Yes

    1. No
15. Please Explain
17. Why do you wish to participate in the Citizen Fire Academy?
19. How did you find out about the Citizen Fire Academy?
21. Stay up to date!

    Once your application is submitted, you will be redirected to stay notified about Citizen Fire Academy updates

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23. Submit

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