Safety Survey*

Quick 90 Second Survey

Once the survey is complete, qualified respondents will be selected to receive a limited number of Emergency Preparedness Kits for viewing valuable fire safety information. By submitting the survey, your name will be entered and you may be selected. Remember there's no purchase necessary, so let's get started.

Question Title

* 1. Check any of the dangers you are concerned about.

Home Fire

Carbon Monoxide

Flooding or water damage

Frozen pipes

Home invasion or burglary

Question Title

* 2. How long do you have to escape a home fire?

10-13 minutes

7-10 minutes

4-6 minutes

0-3 minutes

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* 3. Do you have children, pets or both?

Children

Pets

Both

Question Title

* 4. Married, living together, or single:

Married

Living together

Single

Question Title

* 5. Your occupation?

Question Title

* 6. Spouse occupation?

Question Title

* 7. Age range?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Question Title

* 8. Do you own or rent?

Own

Rent

Live with parents

Question Title

* 9. Are you interested in part time work with flexible hours?

full time

Yes

Question Title

* 10. Contact Information (if selected you may be contacted at # listed)

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Safety Survey*

Quick 90 Second Survey

Question Title

* 1. Check any of the dangers you are concerned about.

Question Title

* 2. How long do you have to escape a home fire?

Question Title

* 3. Do you have children, pets or both?

Question Title

* 4. Married, living together, or single:

Question Title

* 5. Your occupation?

Question Title

* 6. Spouse occupation?

Question Title

* 7. Age range?

Question Title

* 8. Do you own or rent?

Question Title

* 9. Are you interested in part time work with flexible hours?

Question Title

* 10. Contact Information (if selected you may be contacted at # listed)

Question Title

* 11. Who sent you this or whose social media post did you click on?