Kern County Maddy Fund Request Form

A portion of the Kern County MADDY Fund has been made available for the purchase of equipment and/or services that are found to be of benefit to the county EMS system at large. This form may be filled out by anyone interested in improving the Kern County EMS System. Each request will be evaluated based on the information provided and the outcome of said evaluation will be presented to EMCAB. The completed form must be submitted no later than 30 days prior to the next scheduled EMCAB meeting in order to provide time for evaluation and presentation. Please complete each box below and submit to the EMS Program Manager for evaluation.
  • Requesting Party Information:

  • Equipment/Service Contact Information: