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Get Alarmed Order Form for Fire Departments

  1. Requestor Information
  2. Shipping Address
    If different from above.
  3. Order Information
  4. Agreement
    By requesting smoke alarms through the Get Alarmed Kansas free smoke alarm installation program by the Office of the State Fire Marshal, I agree to the following (check each following statement)
  5. By typing your name and date, you agree to each of the statements above.
  6. Leave This Blank:

  7. This field is not part of the form submission.