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2. Smoke Alarm and Carbon Monoxide Detector Program

   South Milwaukee Fire Department provides smoke alarm and carbon monoxide detector supplies to families in need. Supplies are provided by a Wal-Mart community grant, and quantities are limited. Please contact the Fire Department with questions regarding smoke alarm requirements, testing or maintenance.

4. First name:*
5. Last name:*
7. Your street address:*
9. Phone number*
10. Email address*
12. Fire Prevention Options

    I'm interested in the following (select all that apply):

    1. Smoke Detectors
    2. Carbon Monoxide Detector
    3. Fire Extinguisher
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14. 1. Receive an email copy of this form.
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