Please complete this Survey.  We want to hear from you!       • Required Fields for Free Glasses • First Name: • Last Name: • Department Name: • E-mail: • Shipping Address: • City: • State: Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming • Zip Code: Phone:     Position with department?:     Career/Volunteer or Combination Department?:     Number of Firefighters in your department?:     Brand of turnout gear currently worn by department?:     Approximately how old is department's gear?:     What is time frame for purchasing new turnout gear?:     Other than turnouts, what other fire protection products are you interested in learning more about or purchasing in the next 90 days?     • Did you see our recent Sperian Fire turnout ad in The 5th Alarm newsletter?: Please Select Yes No     Questions or Comments       Thank you for your interest and for answering these questions. Before you submit this form, please check to ensure we have your full name and department address so we can send you a complimentary pair of Uvex protective eyewear.         Copyright © 2008 Santiam Emergency Equipment. All Rights Reserved. Design by Matt Luckey Illustration & Design.