Police Speaker/Engagement Request Form

Police Speaker/Engagement Request Form

Greensboro Police Department
The Greensboro Police Department values the opportunity to speak and engage with community groups on safety and crime prevention. We will make every attempt to accommodate your request.

Due to the number of requests and limited resources, please note that we may have to schedule alternative dates.

To request a speaker or department appearance, please complete this form at least 30 days in advance of your event. Speaker/Engagement Request Guidelines

Anyone who submits a form should be aware that in accordance with the North Carolina Public Records law, found in North Carolina General Statutes Chapter 132, their e-mail address is considered public record.
Status*
Internal Contact
External Contact
Today's date*

MonthDayYear
Date
Service Requested*

SpeakerOfficerK-9CSITrafficATV TeamOther
Event Details

*Please be aware that officer resources are limited and they may not be able to stay for more than 1 hour.
Requested Date*

MonthDayYear
Date
Requested Time*

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Alternate Date

MonthDayYear
Date
Alternate Time

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Description of Event*
Event address*

Street Address

CityState

Zip Code
Estimated number of attendees
Audience type

ChildrenAdultsSeniorsOther
Specify the ages of the children
Preferred Speaker Topics*

Anti-BullyingBicycle SafetyCommunity WatchDriving SafetyElectronic MonitoringIdentity Theft/Fraud PreventionPersonal SafetyPre-School "Officer Friendly"Residential Security & InspectionRetail/Commercial SecurityRobbery Survival & MitigationSecurity AwarenessTheft PreventionWorkplace ViolenceInteracting with the Police: Know Your RightsCrime Prevention Through Environmental Design (CPTED)Other
Special considerations (if any)
Contact Information
Organization*
Type of organization*

Business CharityChurchCivicSchoolOther
Organization Point of Contact*

First NameLast Name
E-mail*
example@example.com
Phone Number

Area CodePhone Number
Organization Address

Street

Apt Number/PO Box

CityState

Zip Code
Should be Empty: