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EMS Vehicles Grant Assistance Request Form

To access the EMS Vehicles Grant Assistance Program, please submit the below information. Once your information is submitted, you will be contacted by a Grants Assistance Manager within 72 hours.
Thank you!
* - required field 
* Department Name
* Department Address
* Department City
* Department State
* Department Zip Code
* First Name
* Last Name
* Rank/Title
Title/Rank (Other)
* Phone # ex.415-555-1212
* Email
* Confirm Email
* Tax Status
* Staffing Profile
* How many people are in your department?
* How would you describe your department?
* What type of grant assistance are you requesting? Please check all that apply

* Please describe the specific type and quantity of products for which you are requesting funding
Are you replacing inventory?
* Are you authorized to submit grants and purchase for your department?
Additional comments about your project and need
List any distributor you are working with on this project (If any)
By filling out this form and submitting my information, I understand that I may be contacted by a manufacturer regarding my department's equipment needs. I also understand that this is a request for help locating funding and not a grant application.
I would like to receive FireGrantsHelp email newsletters and grant alerts

Note on Procurement Integrity
FireGrantsHelp is compliant with federal standards and guidance for working with departments seeking grant dollars. All assistance offered is by category and non-product specific. FireGrantsHelp does not benefit from, participate in or otherwise influence the procurement process for grant awards. All assistance is product and vendor neutral to avoid any real or apparent conflict of interest. Departments seeking federal grant dollars are responsible for maintaining a conflict of interest policy in compliance with federal guidelines the standards identified in 2 C.F.R. Part 200, including maintaining adequate supporting documentation.