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2. Instructions

   Thank you for your interest in hosting a raffle dinner at a Cosumnes Fire Department fire station. 

   Fire station raffle dinners are offered on a limited basis to support local schools and community organizations. 

   Requests are considered based on availability and alignment with District policy.

   Please review the following before submitting your request:

   • Requests must be submitted at least 90 days prior to the event date.
   • Submission of this form does not guarantee approval.
   • Approved events are subject to operational needs and scheduling availability.
   • Complete all required fields below to ensure your request can be fully evaluated.
4. Applicant Full Name
5. Applicant Email
7. Name of Organization
9. Organization Website
11. Name of Event
12. Date of Event
    Date of Event
14. Description of Event
16. Has the Cosumnes Fire Department donated before to your event?

    1. Yes
    2. No
17. If Yes, what year?
19. Electronic Signature Agreement

    By selecting “I Agree,” I acknowledge that I have reviewed and understand the District’s Charitable Giving Policy. I confirm that my organization’s event will comply with all applicable District policies and requirements. I understand that submission of this request does not guarantee approval or participation by the District and that any approval is subject to availability and operational needs.

    1. I agree.
21. Electronic Signature
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field