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2. To assist the Beavercreek Police Department in serving your needs, please complete this form as part of any invitation for a member of the department to speak at or attend an event or special meeting. The Beavercreek Police Department attempts to accommodate most requests that support the mission of the department and appreciates your patience during the speaking engagement approval process. As a general guideline, we request 14 days advance notice of any event.

4. Name of organization making request:*
6. Nature or mission of organization:*
8. Person to contact:*
9. Contact email:*
11. Contact phone number:*
12. Event date:*
13. Event time:*
15. Alternate date and time:
16. Event location:
18. Topics to be discussed/reason for request:*
20. Time allotted for appearance/speech:*
21. Number of attendees:*
23. Requested speaker (if known):
24. Substitute acceptable?

    1. Yes
    2. No
26. Additional comments/special instructions:

    Please note any special instructions (e.g. photograph, biography, audio visuals requested, etc.) for the speaker in the space provided.

35. A-18-001
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field