Dispatch 713-755-7628
Contact Name
Organization/School/Community Affiliation if applicable
Phone Number
Email
Request Type ---SpeakerMeetingPresentationOther
Speaker Request ---Constable RosenFemale DeputyMale DeputyK9 DeputyAny Deputy
Event Date
Event Description
Event Location / Address
Topic Request
Start Time
End Time
Event Audience ---AdultsChildrenBoth
Estimated Number of Participants
Onsite Contact Name
Onsite Contact Phone Number
Will Audio / Visual be available on location? ---YesNo
Would you like a biography and photo of speaker if available? ---YesNo
Other Comments or Requests
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