Special Event / Speaker Request

Are you looking for a police representative to speak at a group meeting on a specific safety topic?
Are you having a free community event in which you'd like to have an officer(s) attend?

Fill out the request form below. Requests must be made a minumum of three weeks prior to the event.

The police department will make every effort to fulfill your request; however, due to limited staffing some requests may not be filled.

If you have further questions or if you submit a request and do not hear back within two weeks, call or email Nina Phelps: 916-746-1081, nphelps@roseville.ca.us.

Special Event Interest (Police)

* Date of Event

* Time of Event

Name of Organization Hosting the Event

* Name of Event

* Address of the Event

Who is the main contact person for this event?

* Name

Phone (office)

Phone (cell)

* Email

What is the best time to call you?

What is the best way to contact you?

Phone

Cell

Contact person, the day of the event, if different from the main contact

Name

Phone (cell)

Tell Us More About Your Event

What other organizations do you have confirmed to participate in the event?

What other organizations have you invited to participate in the event?

* Approximately how many people will attend the event?

Who or what is your main demographic that will be attending the event?

What services or information would you like presented at the event?

What are you supplying for Police personnel at this event? (Please note: If you are requesting a police representative to staff an information table, you must provide a table, two chairs and shade in warm weather.)

List anybody from the Roseville Police Department you have contacted

* What are you requesting from the Police Department for this event?

* Name of person submitting this form

Security Measure

City of Roseville

Special Event / Speaker Request

Roseville Police Department