University of Minnesota Duluth

 UMD Police Department

Your Information

Your Information - Person requesting services.
* Name:
* Work Phone:  (xxx-xxx-xxxx)
* Phone (During Event):  (xxx-xxx-xxxx)
Event Information - Describe your event for us.
* Event Description:
* Event (Start) Date(s): (M/D/Y)
Event End Date (if multi-day event): (M/D/Y)
* Event Location:  (Building, Room, etc.)
* Event Start Time: (ie, 4 PM, 730 AM, etc.)
* Estimated Event End Time: (ie, 4 PM, 730 AM, etc.)
* Estimated Attendance:
* Number of Officers Requested:  (Estimate if unknown)
* Officers On-Site Start Time:  (Estimate if unknown)
* Alcohol Served at Event?: Yes            
Any Extra Information or Notes?:
Billing Information - How you will pay for the services. See Rates.
* Payment Method:   EFS (University Department/Organization)
  Invoice (Non-University)
EFS #:  (eg., 123-4567)
* Billing Contact Name:
* Billing Contact Phone:
* Billing Address: (Street Address)
(City, State, ZIP)

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The University of Minnesota is an equal opportunity educator and employer.
Last modified on 05/07/15 05:23 AM
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