Request for Centenary Police Services

This form must be completed at least 5 business days before the event.

This form should be completed for any event that meets any of the following criteria:

  1. is open to the public
  2. will cause increased parking problems
  3. has a large anticipated attendance or has persons who will need assistance
  4. has a foreseeable security or liability risk for the College

Your Information

Group or Department
making request
Your First Name
Your Last Name
Your Phone

Event Information

Event Description

Date
Starting Time
Ending Time
Location
Expected # of Guests
Alcohol Involved? yes no
Organization #
Account #

I understand that the Department of Public Safety is responsible for determining the appropriate number of officers to work this event. The Department of Public Safety will make every effort to minimize the cost to other college departments while still ensuring the security of the campus. I agree to pay the overtime cost for the required officers and I understand the account provided will be billed on the payroll following the event.