City of Victoria Form Center

2. The Victoria Fire Department provides free smoke alarms to residents in need.
   Smoke alarms are installed on a first-come, first-serve basis to homeowners. During the installation period, firefighters will also identify possible fire hazards. To sign up to receive a free smoke alarm, please complete the following form.
4. First and Last Name:*
5. Phone:*
7. Address:*
9. City:*
10. State:*
11. Zip Code:*
13. Do you currently have a smoke alarm?:*

    1. Yes
    2. No
14. If you have a multi-story house, how many levels is your home?:*
16. Is your home an apartment?:*

    *We are not able to install smoke detectors in apartments. Please contact your landlord for installation or battery replacement.

    1. Yes
    2. No
18. Number of bedrooms:*
19. How many occupants reside in the home?:*
21. Comments:
Leave This Blank:


23. Submit

* indicates a required field