Keep Kids Fire Safe Foundation™
106 East Poplar Street, Suite 200
Clarksville, Arkansas  72830

info@keepkidsfiresafe.org
Submitted by:
Address:
Phone number:
Email:
Contact name:
Phone number:
Email:
Who performed
the behavior?
Age:
Ages of all family
members involved:
Date of incident:
City where the
incident occurred:
Location where the
incident occurred
(example: kitchen,
bedroom, etc...
Please share in detail
information about the
incident and how the child
helped in a fire-related
incident. Please be as
detailed as possible.
Thank you!
We want to hear from you! If the book, Sparkles
the Fire Safety Dog, helped save the life of
someone in  a fire-related situation, please
let us know by filling out the form below.
All rights reserved by Firehouse Dog Publishing, LLC®. No material on
these pages may be archived, retransmitted, saved in a database, reproduced,
or used without the expressed written consent of Firehouse Dog Publishing, LLC®
106 East Poplar Street, Clarksville, Arkansas 72830. Copyright 2008 - 2010.
106 East Poplar Street, Suite 100
Clarksville, AR 72830
Phone: 479-754-8652
Fax: 479-754-8652
info@firehousedogpublishing.com
   "Sparkles the Dalmatian has her          
paw on the pulse of fire safety."
                                        Chicago Tribune