Fillable REQUEST FOR OFFICERS Kelly Blackwelder These are the

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REQUEST FOR OFFICERS Kelly Blackwelder These are the

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REQUEST FOR OFFICERS
These are the guidelines for requesting officers for working off duty. The pay rate is $35.00
per hour for each officer working (with a minimum of 4 hours paid). Please understand this
service is on a voluntary basis. Submit completed request to Lt. Mike Brewer at
mbrewer@elon.gov
NAME OF REQUESTOR:
ADDRESS OF REQUESTOR:
PHONE NUMBER OF REQUESTOR:
EMERGENCY CONTACT & PHONE:
NAME OF EVENT:
LOCATION OF EVENT:
DATE OF EVENT:
DURATION OF EVENT: NUMBER OF OFFICERS
I have read and understand the following guidelines for request for officers for off duty
employment.
Signature Date
OFFICE USE BELOW
NAME OF OFFICER(S) WORKING EVENT: ____________________________________
_________________________________ ______________________________________
_________________________________ ______________________________________
Kelly Blackwelder
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Completed 9 February 2021

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