Injury Prevention Program Registration

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Use the form below to request a FREE copy of the Smart Kids! Safe Kids! Injury Prevention Curriculum.

PRIVACY NOTICE: Seattle Fire Department will not use the information you provide below for any purpose other than to contact you to give you more information about the Smart Kids! Safe Kids! Injury Prevention Curriculum and/or the Smart! Kids! Safe Kids! quarterly newsletter.

(*) = Required Field

Request Form Information (Required)

I would like a free copy of the Smart Kids! Safe Kids! Injury Prevention Curriculum sent to me.

Preschool/Group Name:

No. of Children Using Curriculum:

Teacher Contact Name:

First:	*
Last:	*

Daytime Phone:

- - * Ext:

Email Address:

Business Address:

Street:	*
City:	*
State:	*
Zip:	*

Mailing Address:

Check here if the mailing address and business address are the same.
Street:
City:
State:
Zip:

Smart Kids! Safe Kids! Quarterly Newsletter

Yes, I would also like to receive the Smart Kids! Safe Kids! Newsletter
with fire safety and exciting program information (Optional).

Submit Registration Form

If you have questions or need assistance, email the Public Education Office .

Preschool Fire Safety Program | Top

Last Modified: June 26, 2009

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