REQUEST FOR FIRE SERVICE VEHICLES & APPARATUS

Fire Service Apparatus Donation Request Form

If your Fire & EMS department has been impacted by a catastrophic event, and either have no apparatus to provide service and/or severe mechanical failure rendering the vehicle(s) useless, please fill out this form to submit your request to the VFCA. Requests must be specific to fire apparatus, ambulances, small utility and support vehicles.

Organization Name*(Required)

Name(Required)

First Last

Address(Required)

City(Required)

State(Required)

Zip Code(Required)

Email(Required)

Phone(Required)

Please Describe Current Need & Financial Constraints(Required)