Use this form to request one or more of the crime prevention programs/ presentations offered by the Christiansburg Police Department.

Please submit this request form at least two weeks in advance to allow ample time for the Christiansburg Police Department to prepare for your program request.

Contact Information

Name:*

Business or Organizational Affiliation (if applicable):

Telephone (Numbers only; Ex. 5403826128):*

E-Mail:*

Program Information

Please select the program(s) you are interested in.*

Neighborhood Watch Meeting Fraud and Scams Residential Security Assessment Personal Safety Internet Safety Identity Theft Robbery Prevention

Business Watch Business Security Assessment Bring a Police Car to an Event Fingerprinting Kids Police Department Tour Talk on Programs Offered by the Police Department Other

If Other, Please List Program Requested:

Preferred Date of Presentation:*

Secondary Date (if primary date is not available):

Time of Program (Please Indicate AM/PM):*

Location of Program:*

Approximate Number of Attendees:*

Approximate Age Range of Attendees:*

Please provide additional information pertinent to the event, such as whether it is a special public event or regular meeting, time limit for presentation, etc.