Speaker/Program Request

The Lenexa Fire Department welcomes the opportunity to talk about the fire profession. Use this form to request a speaker or program about safety, careers, preschools, daycares, etc.

Event Information

Group/Business Name

Program Location*

You must enter an event address.

Address Line 2

City

You must enter a city for the event location.

State

You must enter a state for the event location.

Zip Code

You must enter a zip code for the event location.

Location Notes

Event Date*

You cannot pick a date closer than 14 days out; dates in October are unavailable.

You cannot pick dates less than 14 days out or in October.

Event Start Time*

Times before 8:00 AM are unavailable.

Event times must be after 8am.

Participant Information

Adults (65 and over)

Adults (18-64)

Youth (High School)

Youth (Jr. High School)

Youth (Elementary)

Youth (Kindergarten)

Youth (Preschool)

Contact Information

Contact Person*

You must enter a contact name.

Email*

You must enter a contact email.

Would you like an email copy of your request?

Primary Phone*

You must enter a primary contact phone.

Text Only

Any unavailable times?

Secondary Phone

Text Only

Any unavailable times?

Other Contacts or Notes

Preferred Method of Contact

I prefer to be contacted by email.

I prefer to be contacted by phone.

I prefer to be contacted by text message.

Additional Information

Activities Requested

Event Goals

Additional Comments

Submission of this form does not guarantee your selected date by the Lenexa Fire Department. It does not grant permission for use of the Department name or logo in any advertisement, or connect the Department in any manner to your request.

These are on-duty crews; the crew may need to leave on an emergency call at any time.

If you wish to mail your request, send it to:

If you would prefer to phone or fax in your request, contact: