Fill all of  the required information.  Partial forms may not be processed.  Submit your request at least three weeks prior to the event to allow time to locate and confirm a representative.

We request that our speakers be the first item on your agenda or program, unless other arrangements are made between you and the speaker after confirmation.


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REQUEST A POLICE DEPARTMENT SPEAKER AT MY EVENT/MEETING
Please submit your request at least three weeks prior to the event to allow time to locate and confirm a representative.
 
Meeting/Event Information
Date of meeting/event:  
Start Time: End Time: 
Address of meeting/event:  
Name of organization/association hosting meeting/event:  
Name of meeting/event, if any:  
  
Primary Contact/Requestor Information
Name: Phone #: 
Email:    Is this a cell phone? Yes No 
Best method of contact?Cell Phone Text Email 
Best time to contact you? Morning Afternoon Evening 
Will you attend the meeting/event? Yes No  
  
Alternate Contact Information (Optional)
Name: Phone #: 
Email:    Is this a cell phone? Yes No
Best method of contact? Cell Phone Text Email 
Best time to contact? Morning Afternoon Evening 
Will this person attend the meeting/event? Yes No  
  
Tell Us More about Your Meeting/Event

What topic/information would you like covered?

How many attendees are you expecting?
What is the general demographic of the attendees?
How much time will be allotted for the speaker?
Will there be a computer or laptop / screen / projector available for the speaker?
Will there be a microphone for the speaker, if needed?

We request that our speakers be the first item on your agenda or program, unless other arrangements are made between you and the speaker after confirmation.



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