Trucking Summit Delegate Application

Please complete the below form to apply for the Summit. Make sure to complete the entire form and then click the blue "Continue" button. Please feel free to call Katie Sieracki at 847-423-2991 with any questions. We look forward to reviewing your application!

Event: 2020 Fire Chiefs Summit
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Please tell us about your organization:

What population size does your department serve?

How many paid and/or volunteer firefighters are in your department?

How many EMTs and/or Paramedics are in your department?

Tell us a little about your department (2-5 sentences).

Tell us a little about yourself - your background, years in the industry and your current scope of responsibility. Are you a sports fan, pet owner, or world traveler? Tell us that too!

What do you think your department is doing well right now?

What keeps you up at night regarding your department?

What other Fire Chiefs or Fire Departments would you recommend we include in the Summit?

If you could ask a room full of your peers a question or two about their operations, what would those be?


PROCUREMENT PLANS:

What is your annual department budget?

Are you responsible for the selection or recommendation of products and services for your department?

New Fire Vehicles: What is your department's projected need?

New EMS Vehicles: What is your department's projected need?

Communications Equipment: What is your department's projected need?

Facility Construction or Retrofit: What is your department's projected need?

Incident Management and Accountability Systems: What is your department's projected need?

Breathing Apparatus/Air Systems/SCBA and Supplies: What is your department's projected need for any of this apparatus?

EMS Equipment and Supplies: What is your department's projected need?

Protective Clothing and Apparel: What is your department's projected need?

Nozzles, Hoses, Reels and Couplings: What is your projected need?

Are you a transporting agency?

Hand Tools and Forcible Entry: What is your department's projected need:

What health and wellness programs are you implementing or interested in looking into for your department?

What apparatus vendors would you like to see?

Please list 3-5 products or technologies you're interested in learning more about.

Please give a little more detail about the above.

I Agree: If I am selected to attend the Fire Chiefs Summit, I agree to be present for all sessions, meetings and functions while at the event.

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Please only click the "continue" button once. The application will take a moment to process your responses.