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1. About Your Property

* Indicates required field

Name *

First

Last

Property Address *

Email Address *

2. Activity Details

Date Activity Completed *

Type of Wildfire - Safety Activity *

Brief Description of the Work *

Where Was The Work Performed? *

Was this connected to a Firewise class, meeting or educational activity? *

Number of People Who Participated *

Total Combined Volunteer Hours *

3. Expenses & Materials

Amount Paid (if any) *

Who Paid for the Expense? *

Contractor or Vendor Name *

Invoice or Receipt Number *

Approximately How Much Vegetation Was Removed? (in cubic yards) *

Payment Type *

Upload File *

Max file size: 20MB

4. Additional Information

Additional Information or Comments *

Certification *

I certify that the information submitted is accurate to the best of my knowledge.

What Qualifies?
Examples of qualifying activities include:

Questions:
Email Nicolette Munoz at nicolette.munoz
@nmunozconsulting.com

Report Your Firewise Activity