Deutscher Family Crashed Car Request Form

Thank you for your interest in the Deutscher Family Crashed Car.  Before you request use of the vehicle and trailer, please carefully read through the minimum criteria needed to request and transport the display.  


Event Information
Event Name *
Event Date(s) *
Location of Event *
Number of miles from F-M Ambulance Service (2215 18th St. S. Fargo ND 58103) *
Pick-up Date * (MM/DD/YYYY)
Drop-off Date * (MM/DD/YYYY)
Potential number of people reached *
Type of audience *
Personal Information
Name of event coordinator *
Email address of event coordinator *
Phone number for event coordinator *
Name of requesting/transporting law enforcement agency *
Email address for requesting/transporting law enforcement agency *
Cell phone number for the person who will be transporting the display. If you do not know this right now, please email Kristi with this information at least 24 hours prior to the display pick-up.
Make and model of transport vehicle *
License Plate of Transporting Vehicle *
Minimum Criteria
Are minimum criteria met? (PLEASE MAKE SURE YOU HAVE READ THROUGH, UNDERSTAND AND AGREE TO THESE REQUIREMENTS). Yes     No    
Once submitted, your request will be sent to the advisory board for approval.  Kristi will get back to you in approximately 1 - 2 weeks to discuss approval and any concerns.  

  

Received a bill from us?

Paying your ambulance bill online is fast and easy!

Or call our billing department at 701-234-1222 from 8:00 AM - 4:30 PM, Monday - Friday. 

Tours

F-M Ambulance Service recognizes the benefits of showing the general public what emergency services is about. One way to promote EMS is to provide tours at no cost to the public when ever we are able to. If you are interested in setting up a tour with one of our ALS ambulance units, contact us by email here: 

Check us out on:

F-M Ambulance Service on Facebook F-M Ambulance Service on Twitter F-M Ambulance Service on You Tube

 

 

Need a car seat or bike helmet checked?

Click here for info on the Safety Shoppe!