Create an Account

Fill out the registration form below to gain access to our Grants Portal. Once submitted, you will receive an email confirmation. If you don’t see the confirmation email after registering, be sure to check your Junk or Spam folder.

Applicant Registration

Name *

First

Last Name *

Last

Your Phone Number

Fire Department, Ambulance Company, or Company Affiliation

Email Address *

Enter Email

Confirm Email Address *

Confirm Email

Password *

Enter Password

Confirm Password *

Confirm Password

What are you applying for?

Select the type of Scholarship you are applying for

Your Fire Safe Council's name

Fire Safe Council Address

City

State/Province

Zip/Postal

Your Title/Position within your organization

Your Fire Agency's name

Fire Agency Address

City

State/Province

Zip/Postal

Your Title/Position within your Fire Agency

If you are human, leave this field blank.