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Fire Prevention
Programs
Resources
Burn Survivors
Programs
Camp Beyond the Scars
Burn Survivor Events
Applications
Our Impact
Get Involved
Donate Now
Ways to Give
Special Events
Volunteer
Internship
About Us
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Contact Us
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Imperial County Fire-Safe Kids Presentation Sign-Up
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Imperial County Fire-Safe Kids Presentation Sign-Up
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Please contact plucas@burninstitute.org with questions.
FSK Imperial Valley + Puppet Show Application
Book a Presentation
*
School
*
Ben Hulse Elementary
Imperial County Office of Education
Imperial Cross Elementary
Meadows Union Elementary
Miguel Hidalgo School
Myron D Witter Elementary
Seeley Elementary
Westmorland Union Elementary
Other
If your school is not listed, please email plucas@burninstitute.org
Name
*
First
Last
Email
*
Phone
*
Hidden
School Address (if available)
Street Address
City
What grade levels will be attending the presentation? Select all that apply.
Pre-School
K
1
2
3
4
5
6
What is the estimated number of students attending the presentation?
*
Hidden
Are you requesting a Fire Safe Kids presentation (K-6) or a puppet show?
Presentation
Puppet Show
Will this presentation be in-person or virtual?
*
In-Person
Virtual
What virtual learning platform are you using/will we be conducting the presentation on (Zoom, Google Meets, Microsoft Teams, etc)?
*
Would you like us to deliver informational fire safety goody bags to your school? They include a coloring book, escape plan, home safety checklist, and more.
*
Yes
No
What is the latest date that you would like them dropped off? (We will try our best to get them to you by that date)
*
MM slash DD slash YYYY
Would you be willing to have your class participate in a second posttest a month after their presentation? This test is used to measure how much knowledge students retain over a long period of time and will help the Burn Institute improve their program.
*
Yes
No
Notes
Please let us know if you have any special requests. Thank you.