Demonstration Notification Form
DEMONSTRATION / PICKETING / RALLY NOTIFICATION
What type of Demonstration Event Are Your Reporting?
*
DEMONSTRATION
PICKETING
MARCH
RALLY
Other
Date and Time of Event
*
/
Month
/
Day
Year
Date
1
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10
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12
:
Hour
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59
Minutes
AM
PM
AM/PM Option
Until End Date and Time
*
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Month
/
Day
Year
Date
1
2
3
4
5
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9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location of Event
*
(Street Address, Block, and/or Intersection)
How Many People Will Be Attending?
*
Estimated
Average Age In The Group?
*
Estimated
Describe The Nature Of The Event
*
Briefly describe what this event is about.
0/200
Additional Information
Organization
Address
Street Address
Street Address Line 2
City
State
Zip Code
Organization Phone Number
*
Format: (000) 000-0000.
Contact Person
*
First Name
Last Name
Contact Person Phone Number
*
Format: (000) 000-0000.
Please verify that you are human
*
Submit
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