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Police Speaker Request Form
To request an appearance or a speaker from the Greensboro Police Department, please complete this form at least 30 days in advance of your event. Speaker 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, his or her e-mail address is considered public record.

The Police Department values the opportunity to speak 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.
1. Today's Date:

2. Service Requested:


Contact Person

3. Organization:

4. Name:

5. Type of Organization:

6. Address:

7. City, State, Zip:

8. E-mail:

9. Phone:

10. Mobile Phone:

Event Details:

11. Requested Date & Time for Appearance:

12. Alternate Date & Time for Appearance:

13. Event Date & Time (if different):

14. Description of Event:

15. Event Address: (including any specific location details or directions)

16. Event Phone:

17. Number of Attendees:

18. Audience Type:


19. Special Considerations:

20. A/V Equipment Available:
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