Special Event Security Request Form Event Information* Event Staffing Request The University of Tennessee Police Department schedules sworn and non-sworn personnel to work special events on campus. Please review the Terms and Conditions prior to requesting police services. Terms and Conditions: Requests for service should be submitted no less than two (2) weeks prior to your event date in order to allow for sufficient planning. If your request is made with less than two (2) weeks notice there will be no guarantee than an officer(s) will be available for your event. Your organization will be responsible for payment for the personnel assigned to work the event. Hourly rate charges are based on the individual officer assigned to the event, and each officer will bill at a minimum of (4) hours for each event. A minimum of 24 hours notice is required for cancellation of the request for police services. If cancellation is not received or is received less than 24 hours before the scheduled time of the event, your organization will be billed a minimum of four (4) hours for each officer requested. The University of Tennessee Police Department will be responsible for assessing the proper number of officers needed based on the information you provide such as crowd size, type of event, location, etc. Name of Event*Starting Date of Event* MM slash DD slash YYYY Ending Date of Event* MM slash DD slash YYYY Scheduled Event Time*eg. 5PM - 7PM.Event SponsorAlcohol to be served?* Yes No Estimated Attendance*Participant University Affiliation* Select All Students Staff Faculty General Public Other if you selected other affiliation please describe the university affiliation below.if you selected other affiliation please describe the university affiliation below.Reason for Police Presence?The reason police presence is being requested for this event.Contact Information (Day of Event)Name* First Last Phone Number*Email Address* Billing InformationBilling Account Number*Billing Name*Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code LocationPrimary Location*Primary Location Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Secondary LocationSecondary Location Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code NameThis field is for validation purposes and should be left unchanged. Δ