Sparky’s Wish List: Partnering for Fire-Safe Communities
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Create Wish List

Please enter your information below to create your wish list.

Personal Information

First Name (required)
Last Name (required)
Title (required)
Email (required)
Verify Email (required)
Password (required)
Verify Password (required)
 

Password must be at least 6 characters, and contain both lower and upper case letters and a number.

Wish List
Event Title: (optional)
(Open House, Classroom Visits, Other)
Event Date: (optional)
If you would like to receive your educational materials before a planned event - please provide date. We recommend not giving a deadline of less than a month.
 

Registrant Information
First Name:*
Last Name:*
Fire Dept. Name:*
Are you the Fire Chief? (required)
If you are not the Fire Chief, please provide the name and email of your Fire Chief so we can send notification of this Wish List. You must attain approval from your Fire Chief to receive purchased shipments of fire prevention materials. We will need a valid email address for your Department's Fire Chief in order to make your List public.
Fire Chief's First Name:
Fire Chief's Last Name:
Fire Chief's Email:
The address you provide will be the shipping address for your Wish List products. Do not use a PO box - you must provide a street address for delivery.
Address Line1:*
Address Line2:
Country:*
City:*
State:*
Zip/Postal:*
Daytime Phone Number:*
Evening/Cell Phone Number:
* (required)
 

Wish List Greeting

Enter a greeting that will be displayed at the top of your wish list when viewed by the community.

Sample message: The Bradford Fire Department needs your help with stocking up on fire safety education materials for our community outreach programs. Times are lean and help is needed to educate children and remind adults about fire prevention and what to do in the event of a fire. Help us save lives!

Wish List Donation

Enter a donation link that will be available for your donators.

Sample Donation Link: https://www.paypal.com/donation/

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Image: (200kb max)
 
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