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2. Smoke Alarm Installation Program
4. Instructions

   If you are interested in the smoke alarm home installation program please fill out this form and someone will get back to you to talk about the program and schedule the install.

6. Name*
7. Home Address*
9. Phone #*
10. Email*
12. How many Smoke Alarms/Detectors do you currently have in your home?
13. Are your smoke alarms/detectors hard-wired?*
    -- Select One --YesNoUnsure
15. Terms & Conditions

    Homes with hard-wired detectors are not included in this program. All detectors installed by the Richton Park Fire Department are the 10-year sealed battery free-standing alarms.  

17. Electronic Signature of Complainant*

    1. Electronically Signed
18. Date
Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field