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Police Guest or Speaker Appearance Request
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This form has been modified since it was saved. Please review all fields before submitting.
Instructions
If you would like a Dayton Police Officer to be a guest or a speaker at your upcoming event, please fill out this request form AT LEAST TWO WEEKS prior to the event. We ask that you provide details about the event, speaker/guest requirements, agenda or itinerary. This is also applies for requesting officers to bring equipment for display at your event. You will be notified as soon as possible regarding your request.
REQUESTOR INFORMATION:
Sponsoring Organization
*
Organization Website
Point of Contact Name
*
Contact Email Address
*
Organization Address
City
State
Zip Code
Contact Phone Number
*
Contact Fax Number
EVENT/PROGRAM DESCRIPTION
Event Name
*
Estimated Attendance
*
Theme / Purpose / Brief Description
*
Onsite Contact Name
*
Onsite Contact Phone Number
*
Event Date/Time
*
Event Date/Time Start Date
Event Date/Time Start Time
—
Event Date/Time End Date
Event Date/Time End Time
Event Type
*
-- Select One --
Public Event
Private Event
Indoor Event
Outdoor Event
Formal/Gala Event
Choose all that apply to your event
Time Officer(s) Would Attend
*
Venue Name & Building/Room Number
*
Venue Address
*
Type(s) of Services/Equipment Requested
*
Media Invited
Yes
No
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