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Brevard County Fire Rescue Display/Speaker Request Form

Please read this first before you start.

Brevard County Fire Rescue Display/Speaker Request Form

Please provide at least one (1) month advance notice when scheduling your event so that we may accommodate your specific needs. This time frame will allow us adequate time to process your request and to notify all fire rescue participants. We will make every attempt to accommodate each request on an individual basis. Please complete this form and then click on the Submit Form button at the bottom of the page. A representative will contact the requestor within two (2) business days. If you have any questions or concerns, please contact Fire Prevention at 321-637-5660.

Contact Information (Required)
Organization Name *
First Name * Last Name * MI
1st Phone Number * 2nd Phone Number Email Address
-- --
Address Information (Required)

Address information is separated by: Street Number, Street Direction, Street Name, Street Type, Unit Type, and Unit Number.
City and Station are automatically populated based on your 5-digit Zip Code.

Street Number * Street Direction Street Name * Street Type * Unit Type Unit Number
Zip Code * City, State
Populated by Zip Code
Request Information (Required)
At least one (1) month advance notice when scheduling your event.
 Please Choose One Request Type (Required) 
Number of Adults * Number of Children * Children Age Range *
Event Date * Start Time * End Time *
Reason for your request/Additional Information (Only a maximum of 500 characters are allowed) *
You have 500 characters available.
Agreement Information (Required)

REMEMBER: At least one (1) month advance notice when scheduling your event.

  
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Brevard County Board of County Commissioners
2725 Judge Fran Jamieson Way, Viera, FL 32940
(321) 633-2000
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Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.