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Smoke Alarm Request

  1. Clinton City Seal
    P.O. Box 199 Clinton, NC 28329
  2. Smoke Alarm Request
  3. In an effort to provide you with the most effective services possible, we would like to find out a little more about you, your household and the level of awareness for fire safety that exists within your home.
  4. Have Smoke Alarms?
  5. In date?
  6. Are you a Landlord?
  7. Do you Rent ?*
  8. 1. Do you have a fire escape plan within your home ?
  9. 2. Do you have a working in-date fire extinguisher in your home?
  10. 3. Have you been shown how to use a fire extinguisher?
  11. 4. Do you conduct safety drills?
  12. 5. Would you like to recieve additional information for fire safety?
  13. Leave This Blank:

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