| Your
Information - Person requesting
services. |
|
|
|
|
| * Name: |
|
| * Work
Phone: |
(xxx-xxx-xxxx) |
| * Phone
(During Event): |
(xxx-xxx-xxxx) |
| Email: |
|
|
|
| Event Information -
Describe your event for
us. |
|
|
|
| * Event
Description: |
|
| * Event (Start) Date(s): |
(M/D/Y) |
| Event End
Date (if multi-day event): |
(M/D/Y) |
| * Event
Location: |
(Building, Room, etc.) |
| * Event
Start Time: |
(ie, 4
PM, 730 AM, etc.) |
| * Estimated Event End Time: |
(ie, 4 PM, 730 AM, etc.) |
| * Estimated Attendance: |
|
| * Number
of Officers Requested: |
(Estimate if unknown) |
| *
Officers On-Site Start Time: |
(Estimate if unknown) |
| * Alcohol
Served at Event?: |
Yes
No |
| Any Extra
Information or Notes?: |
|
|
|
| Billing Information - How
you will pay for the services. See Rates. |
|
|
|
| * Payment
Method: |
EFS (University Department/Organization)
Invoice (Non-University) |
| EFS
#: |
(eg.,
123-4567) |
| * Billing
Contact Name: |
|
| * Billing
Contact Phone: |
|
| * Billing
Address: |
(Street Address)
(City, State,
ZIP) |
| |
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