Prescribed Fire Survey

Would you like to be notified when prescribed fires occur in the Albany Pine Bush? *

Yes

No

First Name

Last Name

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Email Address

How would you like to be notified? *

Mail me a postcard at the beginning of each year

Email me a link to your Facebook page where information is posted on the day of each prescribed fire

Call me on the phone each day of a prescribed fire

Email me each day of a prescribed fire

Did you notice any prescribed fires in 2019? *

Yes

No

Did the 2019 prescribed fires affect you in any way? *

Yes

No

If yes, how? Please check all that apply. *

Would you like us to give you a follow up phone call to answer any questions? *

No

Yes

First Name *

Last Name

Phone Number *

When is the best time to reach you at this phone number?

Would you like to sign up for our monthly newsletter? We will not share your info with anyone and you can unsubscribe at any time. *

No

Yes

Email Address: *

Any other comments?