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Salem Fire Fighters Breakfast: A Fundraiser for the Salem Fire Foundation to purchase new equipment for the Salem Fire Department

Please use this form to hold your seat for the Salem Fire Fighter Breakfast

Thursday, October 17, 2019 at Roth's West Salem Event Center

Doors Open: 7:00 am; Program Starts 7:30 am

Registration information
All guests must fill out an individual registration form. For multiple attendees email You can select your table captain or ask to be assigned to a seat from this form.

First Name
Last Name


Address Line 1
Address Line 2
ZIP/Postal Code


Select a table captain from the list below or choose "Assign me to a table" at the top of the list.
If you would like to sponsor you can do that now or find a hard copy of the sponsor form at
Makes Checks Payable to:

Salem Fire Foundation

PO Box 2920

Salem, OR 97308-2920

The Salem Fire Foundation is a registered 501(c)(3) nonprofit organization and all donations are tax deductible. Tax ID 47-2328706

Honor a survivor or memorialize someone special.