If you have already had a defensible space inspection please apply for your voucher by completing this form. If you have not had a defensible space inspection go back to STEP 1 on this page.

Only Nevada Fire Safe members are eligible to receive a rebate. If you are not a member please join using our online membership form or download a membership application to mail in. You may return to this form to request a voucher as soon as you have signed up online. If you are unsure of what Chapter you may be affiliated with you can apply as an "at-large" member.

	*Required Field
*Property Owner's Name:
*E-Mail Address:
*Area Code/Telephone:
Alternate Phone:
*Property Address:
*City:
*State:	*Zip Code:
Check here if your mailing address is same as property address, otherwise fill in below.
*Mailing Address:
*City:
*State:	*Zip Code:
*Date of initial D-space Inspection:
*Name of Inspector:
*Are you a member of the Fire Safe Council?	Yes         No
If the answer is no you need to become a member before you are eligible to receive a rebate. You may join by using our online membership form or download a membership application. If you sign up online you may return to this form immediately to request your voucher.
If Yes - Chapter Affiliation:	(if unsure enter "Unknown")