University Police Department

Crime Prevention Program Request Form

* Required
* Name of Department/Organization
Type of Event
*Specific Topic
*Contact Person
WFU ID Number (if applicable)
Status (check one)
If Status is Other, Specify
* E-mail Address
Phone Number
* Date of Event
* Location of Event**
* Beginning Time
* Ending Time
* Anticipated Number of Participants
Comments

**Location must be reserved through proper channels and paid for by requestor. Please confirm location reservations prior to submitting this request. This form is a request only. Date of program is not final until you have received confirmation from the University Police Department. For further information, please call 758-3567 PRIVACY POLICY: This is a secure form - all submissions are encrypted in transit. Wake Forest does not use the information for other than its intended purpose. It is neither distributed nor sold.

     Wake Forest University
     Winston-Salem, North Carolina
     Information: 336.758.5000