FIRE DEPARTMENT

Emergency Contact Form for Businesses
within Seminole County

This information is intended to keep the Fire Departments and Law Enforcement Agencies within Seminole County updated with your current business information. The information will be used by our emergency responders and kept by the local emergency dispatch centers. * indicates required information BUSINESS INFORMATION * Business Name: (As it appears on your store front) * Address: N S E W NW Alley Avenue Boulevard CL Circle Court Cove Drive Lane Loop Parkway Place Plaza Point Road Run Square Street Terrace Trail Way (Street Number) (Prefix)      (Street Name)            (Street Type) (Suite Number)                 (Building Number) * City: Altamonte Springs Apopka Casselberry Chuluota Fern Park Geneva Heathrow Lake Mary Longwood Maitland Oviedo Sanford Winter Park Winter Springs * Zip: * Phone Number: * Business Type: Assembly Day Care Detention and Correctional Educational Business Industrial Mercantile Storage Ambulatory Health Care Health Care Apartment Building Dormitory Hotel Lodging or Rooming House Residential Board and Care (Business Type Descriptions) EMERGENCY CONTACTS First Contact * Name: * Primary Phone Number: Secondary Phone Number:   Second Contact Name: Primary Phone Number: Secondary Phone Number:   Third Contact Name: Primary Phone Number: Secondary Phone Number: