Police Guest or Speaker Appearance Request

2. 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.
4. REQUESTOR INFORMATION:
6. Sponsoring Organization*
7. Organization Website
9. Point of Contact Name*
10. Contact Email Address*
12. Organization Address
14. City
15. State
16. Zip Code
18. Contact Phone Number*
19. Contact Fax Number
23. EVENT/PROGRAM DESCRIPTION
25. Event Name*
26. Estimated Attendance*
28. Theme / Purpose / Brief Description *
30. Onsite Contact*
31. Onsite Contact Cell Phone Number*
33. Event Date/Time*
    Event Date/Time Start Date

    Event Date/Time Start Time

    —

    Event Date/Time End Date

    Event Date/Time End Time
34. Event Type*
    -- Select One --Public EventPrivate EventIndoor EventOutdoor EventFormal/Gala Event

    Choose all that apply to your event
36. Time Officer(s) Would Attend*
37. Venue Name & Building/Room Number*
39. Venue Address*
41. Type(s) of Services/Equipment Requested*
43. Media Invited

    1. Yes
    2. No
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit

* indicates a required field