CITY OF BETHLEHEM
POLICE DEPARTMENT
COMMUNITY REQUEST FOR SERVICES
TYPE OF REQUEST OR EVENT:
TOUR
LECTURE
SECURITY SURVEY/RISK ASSESSMENT
COMMUNITY EVENT
OTHER
DATE OF REQUEST
RECEIVED BY
SUPERVISOR’S APPROVAL
DATE
REQUESTOR’S NAME
REQUESTOR’S ADDRESS
ORGANIZATION OR GROUP NAME
PHONE NUMBER OF CONTACT PERSON: (H)
(W)
(P) (C)
SERVICE REQUESTED FOR-DATE
TIME
ATTENDEES *** ADULTS
CHILDREN TOTAL
LOCATION OF SERVICES REQUESTED
MATERIALS/GIVEAWAYS REQUIRED
OFFICER(S) ASSIGNED
DATE ASSIGNED
ASSIGNMENT COMPLETED-DATE:
TIME STARTED
TIME ENDED
NUMBER OFATTENDEES-ADULTS CHILDREN TOTAL
OFFICER(S) PRESENT
INSTRUCTIONS
COMMENTS
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