Tulsa Police Department
Public Education
Program Request
When will the program take place? Do Not Use Colons ( : ) in the time block.
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
A.M.
P.M.
Mo
Day
Year
Day of Week
Time
AM/PM
Name of Group
Type of Program
Expected Attendance
Age of Audience
30 or Less
30-50
50-100
100 or More
Family
Senior Citizen
Adult
High School
Middle School
Elementary School
Pre-School
Location Name
Location Address
City
Contact Person
Best Time to Contact
Any Time
Morning
Evening
Weekend
Residence Phone
Work Phone
Email Address
(
)
(
)
Comments
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