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Georgia Firefighter Clown Society

Georgia Fire Educators Survey

Agency
2007 Reporting Quarter
Educators Name:
E-Mail Address:
Number of Primary Children Reached
Number of Secondary Children Reached
Number of Adolescent Children Reached
Number of Adults Reached
Method(s) Used: Clowning/Puppets
Method(s) Used: Demo/Lecture
Method(s) Used: Station Tour(s)
Method(s) Used: Distributed Literature
Any Fire Related Deaths
# of Primary Children Deaths
# of Secondary Children Deaths
# of Adolescent Children Deaths
# of Adult Deaths
Any Rescues/Saves
# of Primary Children Saves
# of Secondary Children Saves
# of Adolescent Children Saves
# of Adult Saves
Save Incident #
Save Narrative
Rescue Attributed to:
Other comments:
  

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