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* 1. What is your name?

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* 2. How many total years of fire service experience do you have?

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* 3. What fire or EMS high school program are you involved with?

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* 4. How would you best describe your role within the program? Please check as many as are applicable.

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* 5. How many years have you been involved with this program?

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* 6. Where is the program located?
Please include city, state, and zip code.

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* 7. Please check any of the following certifications that students receive upon completion of the program:

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* 8. What grades are eligible for your program? Please check all that apply.

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* 9. What is your program's instructional approach?

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* 10. Who funds the program? Please check all that apply.

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* 11. What metrics do you use to evaluate your program's performance? For example, some schools track the number of students who are employed or volunteer in the emergency response professions after graduation. Please list any outcomes that your program measures.

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* 12. Please provide any other information you'd like to share about the program, including information such as curriculum, student demographics, affiliations with fire departments, vocational-technical schools, etc.

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* 13. How familiar are you with the National Fallen Firefighters Foundation's Everyone Goes Home program and the 16 Firefighter Life Safety Initiatives?

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* 14. Do you discuss the Everyone Goes Home program and/or the 16 Firefighter Life Safety Initiatives in your cadet program?

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* 15. If you are interested in attending the High School Fire and EMS Cadet Program Symposium July 9-11, 2019 in Pflugerville, Texas, please give us your email address:

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* 16. Below are some potential presentation topics for the Symposium. Please check any that may be of interest to you:

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* 17. One of the key objectives of the Symposium is to find ways to share information with other programs across the country. Do you have any ideas you'd like to share with us about how we can do this?

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* 18. Do you have any other comments, ideas, or suggestions for us regarding this event?

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