FireSmart Home Assessment Enter your information below to register. Fire Services personnel will contact you to confirm a date and time. Name First Name Last Name Contact Information*Please select a way for us to contact you to schedule and confirm your assessment. Phone Email EmailEnter your email and phone number to have Athabasca County Fire Services contact you to confirm a time for your Fire Smart home assessment. Your email address Confirm your email Phone numberAddress*Enter your rural address, street address, or legal land description so personnel are able to locate your home. Address Hamlet/Subdivision Legal Land DescriptionIf you have a Legal Land Description and no rural address, use this field. CAPTCHAThe personal information collected on this form will be used to administer your Fire Smart Home Assessment and is collected under the authority of Section 33 (c) of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection and use of this information, please contact the Athabasca County FOIP Coordinator at 3602 – 48 Avenue Athabasca, AB T9S 1M8, 780-675-2273.NameThis field is for validation purposes and should be left unchanged. Δ