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2. Kansas Fire Prevention code recommends any commercial fire suppression or fire alarm and detection business doing business in the State of Kansas to register with the Office of the State Fire Marshal.
4. Business Name
5. Contact Name
7. Mailing Address
9. City
10. State
11. Zip Code
13. Phone
14. Fax
16. Email
18. Fire Sprinkler Systems
    Indicate what is appropriate for your business.
20. Highest level of certification: NICET
    -- Select One --Level ILevel IILevel IIILevel IV
21. Provide copy of certification*
23. Indicate services provided by your company

    Check all that apply

    1. Design
    2. Installation
    3. Repair/Modification

    1. Inspect
    2. Quarterly Maintenance
    3. Annual Maintenance
25. Fire Alarm Systems
    Indicate what is appropriate for your business
27. Highest level of certification: NICET
    -- Select One --Level ILevel IILevel IIILevel IV
28. Provide copy of certification*
30. Other certifications:
32. Indicate services provided by your company

    1. Design
    2. Installation
    3. Repair/Modification

    1. Inspect
    2. Quarterly Maintenance
    3. Annual Maintenance
34. By typing your name and date below, you attest that all design, installation, inspecting, testing, and maintenance performed by this company will be performed in accordance with all applicable standards.
36. Name
37. Date
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field