2. 

4. The Edmond Fire Department smoke alarm program is funded through donations. We have a limited supply of smoke alarms available. The number of smoke alarms installed varies based on home size and risk factors. All addresses must be located within Edmond city limits. Address Locator

6. Contact Information
8. First Name*
9. Last Name*
11. Location *

    * Note: All addresses must be located within Edmond city limits. Address Locator

13. Phone #*
14. Email*
16. Residence Information
18. Do you rent or own?

    1. Own
    2. Rent
19. Type of residence

    1. Apartment
    2. Single family
    3. Duplex/Triplex/ Condo
20. Age of home

    1. Less than 10 years old
    2. More than 10 years old
    3. I don't know
22. Sleeping areas*
23. Home floors*
25. There is a resident under the age of 18 in the home?

    1. Yes
26. There is a resident over the age of 64 in the home?

    1. Yes
27. There is a resident that is audio/visually impaired?

    1. Yes
29. Do you have smoke alarms?

    1. Yes
    2. No
31. What type of alarm(s) are you currently using?*
    -- Select One --Battery onlyBattery and wiresWires and no batteryUnknownThe Fire Department supplied the Alarm(s) I have
32. How many smoke alarms?*
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34. 1. Receive an email copy of this form.
35. Email address

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36. Submit

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