EVENT REQUEST FORM

Presentation / Event Request Form

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Organization / Event Sponsor


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Date & Time are tentative until they are confirmed.

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Address of presentation.

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City of presentation.

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State of presentation.

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Zip code of presentation.

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Please select what presentation you would like.

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Please describe the type of presentation.

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Please describe event.

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Type of Audience

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Estimated Numbers of Attendees

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Are there Dignitaries Attending?

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If Yes or Invited, Please List.

EVENT CONTACT INFORMATION
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Name

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Contact Number

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Cell Phone (If Applicable)

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Email Address

LOCAL NOTIFICATION
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Have you notified your local police department about the event?

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If Yes, please provide contact name and number.

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I Am Not A Robot : )

Sheriff's Office

building2 Bergen County Plaza
       Hackensack, NJ 07601

phonePhone: (201) 336-3500

faxFax: (201) 752-4234

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Bergen County Sheriff's Office 

building10 Main Street • Hackensack, New Jersey 07601

phonePhone: (201) 336-3500

faxFax: (201) 487-5137

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