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2. School Visit Request

   Please complete and submit this form to request a school visit from the Fire Department's Public Education Officer.  The Public Education curriculum is geared to grade levels Kindergarten and First, or Second and Third.  Therefore, school visits may contain combined classes of Kindergarten and First Grade or Second and Third Grade students.

4. Select School*
   -- Select One --Fairsite School ReadinessGalt Adventist SchoolLake CanyonMarengo RanchRiver OaksValley OaksVernon E. Greer Arlene HeinJessie BakerEdna BateyArthur C. ButlerCaroll ElementaryEdna BateyElitha DonnerElk GroveEllen FeickertElliott RanchFlorence MarkoferFoulks RanchFranklinHelen Carr CastelloJames McKeeJohn EhrhardtJoseph SimsMarion MixMiwok VillagePleasant GroveRaymond CaseRoy HerburgerSt. Elizabeth Ann Seton Catholic SchoolSt. Peter's Lutheran SchoolStone LakeZehnder Ranch Elementary

   EGUSD or Galt elementary schools not listed are outside of the Fire Department's jurisdiction.

5. Number in Attendance*

   Provide an estimated number of students who will participate in the school visit.

6. Number of Classes*

   Please provide the number of classes participating in the school visit.

8. Grade Level*

   Provide grade level(s) of students participating in the school visit.

   1. Kindergarten/First
   2. Second/Third
12. Date & Time

    Provide dates and times for your first, second, and third choice for a school visit.

14. First Choice*
    First Choice

    First Choice
16. Second Choice
    Second Choice

    Second Choice
18. Third Choice
    Third Choice

    Third Choice
22. Contact Information

    Provide the name, email address, and phone number of the person who will be coordinating the school visit.

24. Contact Person Name*
25. Email Address*
27. Phone Number*
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field