Click to Home
About UsDepartmentsCommunity RelationsI'm Looking For...
Go To Search
Contact Us
Chino Valley Fire District
14011 City Center Drive
Chino Hills, CA 91709
Ph: 909-902-5260

Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Fred L. Burns Community Service Award

  1. Nomination period is midnight of January 1st to midnight of December 31st. Please use this form to nominate an exemplary individual for the Fred L. Burns Service Award. Nominees must be someone who has made a significant contribution to the Chino Valley Fire District in the area of furthering the District’s Mission Statement and who has made a significant contribution to the Chino Valley. The Mission of the Chino Valley Independent Fire District is to protect the lives and property of the community from the detrimental effects of fires, medical emergencies and other hazardous conditions.

  2. (If applicable)

  3. Please provide two references who are familiar with and can verify the scope and extent of the nominee's volunteer service activities. These people may not be the nominator, nominee, or a relative of the nominee. Please make the individuals aware they may be contacted.

  4. Leave This Blank:

  5. This field is not part of the form submission.