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2. It is a proven fact that smoke detectors save lives. With very few exceptions, most fire fatalities occur in homes without a working smoke detector.
4. To qualify, you must be a Watauga resident without a working smoke detector. Please provide your information and Fire Department Representative will contact you to arrange an install date and time.
6. First Name:*
7. Last Name:*
9. Address:*
11. Email:*
13. Phone:*
15. Number of Smoke Alarms Needed?*
    -- Select One --123456 or more
16. How many people live here?*
    -- Select One --123456 or more
17. How many under 17 live here?*
    -- Select One --0123456 or more
19. How many individuals with a disability or an access or functional need live here?*
    -- Select One --0123456 or more
21. How many veterans, military members or military family members live here?*
    -- Select One --0123456 or more
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit Submit and Print

* indicates a required field