Event/Presentation Request Form – Chatham-Kent Police Service

Name(Required)

Phone(Required)

Email(Required)

Alternative Contact

Alternative Phone

Alternative Email

Date(Required)

Time(Required)

Location(Required)

Street Address Address Line 2 City Province Postal Code

Number of Participants(Required)

Age of Participants(Required)

Presentation Hardware

Select all that apply

Is there a projector available for PowerPoint presentations?

Is there a plug/extension cord available to plug in laptop, project and speakers?

Is there a screen, white wall or smartboard available?